Melatonin and the Cardiovascular System

Melatonin (N-acetyl-5-methoxytryptamine) is a neuroendocrine hormone primarily secreted by the pineal gland and also produced in extrapineal tissues such as the retina, lymphocytes, and the cardiovascular (CV) system. This hormone possesses amphiphilic properties, allowing it to penetrate most biological barriers and exert its effects at the subcellular level; it plays an important role in controlling the body's response to circadian rhythms and adjusting to internal and external environmental cues. It also has antioxidant, anti-inflammatory, and antiaging properties. Melatonin's secretion is controlled by daily and seasonal environmental light cycles. Its production is strictly occurs during the night and is inhibited by light. Besides these chronobiotic actions, this hormone possesses vasoactive properties mediated by the plasma membrane melatonin receptors (MT1/MT2) and ion channels expressed in the CV system. The responses triggered by melatonin in the CV system vary depending on the vascular bed analyzed and hormone concentration. Also, MT1 receptors likely mediate vasoconstrictor effects, whereas MT2 receptors mediate vasorelaxant effects. Furthermore, there is a gap in the literature, as very few studies have addressed the effects of circadian variations on the expression of these receptors, pointing to an important area for further investigation. In summary, melatonin is a robust antioxidant agent and free radical scavenger, guarding cells from oxidative damage. Within its wide spectrum of diverse physiological roles, such as maintaining the functional integrity of endothelial cells, thus averting atherosclerosis, a major contributor to CVD, melatonin exhibits antioxidant and free radical scavenging properties, potentially ameliorating cardiometabolic disorders, and, as herein detailed, it has a unique adjunctive therapeutic potential for managing various CVDs via several mechanisms by which melatonin interacts with the CV system. All these issues are herein reviewed, the results of relevant meta-analyses are tabulated and discussed, and the actions and influences of melatonin on the CV system are detailed and pictorially illustrated.