CHANGES IN HEART RATE VARIABILITY WITH COMBINED MELATONIN TREATMENT IN ELDERLY PATIENTS WITH ARTERIAL HYPERTENSION

Objective: To evaluate the effect of melatonin on heart rate variability (HRV) in elderly patients with arterial hypertension (AH). Methods: A total of 82 participants were examined, comprising 42 elderly patients with stage II-III hypertension and 40 healthy volunteers of different ages. The ages of the patients with hypertension and the healthy elderly volunteers ranged from 60 to 74 years. All clinical and imaging studies, along with inpatient treatment, were conducted in the cardiology department of the City Medical Center No. 1 named after K.A. Akhmedov in Dushanbe, the Republic of Tajikistan. The participants were divided into two groups: the main group, which included 22 patients, and the comparator group, which consisted of 20 patients. The control group comprised 40 healthy volunteers, evenly split between young and elderly participants (20 from each age group). In the comparator group, patients received first-line treatment for hypertension, while in the main group, melatonin was added to the regimen. The HRV indices of all patients were studied before treatment and again after three months of therapy using the Varicard-2.51 device (LLC "Institute of Introduction of New Medical Technologies RAMENA", Russia). Results: The study indicates that both experimental and comparator groups experienced a decrease in total power HRV, primarily attributed to a reduction in the high-frequency (HF) spectrum, which signifies a shift towards reduced parasympathetic nervous system activity. Simultaneously, there was an increase in the very low frequency (VLF) spectrum and the LF/HF ratio, suggesting a heightened sympathetic nervous system response. When combined antihypertensive therapy (AHT) was used with melatonin, stabilization of HRV indicators was observed. This stabilization was characterized by an increase in the HF indicator and a decrease in the LF/HF ratio and VLF.Conclusion: The study's results indicated that elderly patients with hypertension exhibit reduced HRV indices. Incorporating melatonin into the combined AHT helps restore the balance between the sympathetic and parasympathetic divisions of the autonomic nervous system and leads to improved prognostic outcomes. This finding should be considered when determining treatment strategies for this group of patients. Keywords: Heart rate variability, arterial hypertension, old age, antihypertensive therapy, melatonin.