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Abstract
To assess the effect of moxonidine on bone metabolism and bone mineral density (BMD) in postmenopausal patients with arterial hypertension (AH) and osteopenia. A randomized, open, clinical trial included 114 postmenopausal patients with AH. All participants were evaluated bone metabolism), BMD, telomerase activity (TA). Randomization was carried out into 2 groups (moxonidine and bisoprolol therapy) using simple envelopes. After 12 months of therapy, a dynamic examination was performed. Both groups showed a positive effect of both moxonidine and bisoprolol on hypertension during treatment both as monotherapy and in the group of patients receiving combined antihypertensive therapy: a decrease in SBP and DBP in the 1st group was 13.6% and 12.8% respectively, and in the 2nd group - 13.7% and 15% respectively, while achieving normal values. In most patients of group 1, normalization of body weight was noted in comparison with group 2 (23.4% and 17.4%, respectively, p = 0.043), delta of body weight in the moxonidine group was -1.89%. The increase in the processes of bone formation in the form of increased markers of OC and Osteoprotegerin and a statistically signifcant increase in TA in patients receiving moxonidine were revealed, while in women who took bisoprolol there were no dynamic changes in bone metabolism rates, there was a tendency for a decrease in BMD and a signifcant decrease in AT. Te detected pleiotropic effect of moxonidine on bone metabolism and replicative cell aging processes will reduce the risk of development or progression of osteopenia and osteoporosis in postmenopausal women with AH.
Highlights
In most patients of group 1, normalization of body weight was noted in comparison with group 2 (23.4 % and 17.4 %, respectively, p = 0.043), delta of body weight in the moxonidine group was –1.89 %
Quercioli A, Montecucco F, Bertolotto M, Ottonello L, Pende A, Mach F et al Coronary artery calcification and cardiovascular risk: the role of RANKL / OPG signalling: CALCIUM SCORE AND CARDIOVAS‐ CULAR RISK
Summary
Моксонидин 0,6 мг/сут+ Периндоприл 10 мг/сут Моксонидин 0,6 мг/сут+ Периндоприл 5 мг/сут. После получения результатов скринингового обследования, при соответствии пациента критериям отбора, проводился Визит включения (не позднее чем через 14 дней после подписания пациенткой информированного согласия), включающий исследование метаболизма костной ткани: уровней остеокальцина (ОК), С-концевого телопептида коллагена 1 типа (Сtx), остеопротегерина (ОПГ), лиганда рецептора активатора ядерного фактора кβ (RANKL), которые определялись методом электрохемолюминисценции на автоматическом анализаторе Elecsys 2010 с использованием коммерческих наборов фирмы Rochе. Ст.) через 2 недели от начала терапии доза моксонидина оставалась прежней, а при сохранении повышенного уровня АД – доза моксонидина увеличивалась до 0,6 мг / сут. При недостижении целевых уровней АД к терапии моксонидином 0,6 мг / сут через 4 недели от начала терапии добавлялся периндоприл в дозе 5 мг / сут. Ст.) через 2 недели от начала терапии доза бисопролола оставалась прежней, а при сохранении повышенного уровня АД – доза бисопролола увеличивалась до 7,5 мг / сут.
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