CORRECTION OF RESISTANT ARTERIAL HYPERTENSION IN PATIENTS WITH CHRONICKIDNEYDISEASE STAGE I–III

Abstract

Aim. The aim was to investigate the use of the I1–imidazoline receptor agonist moxonidine as an ‘add–on’ agent and determine its effect on heart rate variability in patients with CKD st. I–III and resistant hypertension.
 Methods. We investigated the safety and efficacy of moxonidine (200–600 mg) in a group of 35patients with CKD st. I–III whose had prior treatment with three or more antihypertensive medications, although without adequate control [systolic blood pressure (SBP) 145–165 mm Hg and/or diastolic BP (DBP) 95–100 mm Hg]. BP was measured according to internationally accepted guidelines before and after 3 month of treatment with moxonidine used as an ‘add–on’ agent in the patients with CKD st. I–III and resistant hypertension. Age ofpatients was 53±5,8 years. Glomerular filtration rate (GFR) before treatment was 68,7±23,0 mL/min/1,73m 2. Before and 3 months after treatment, we determined improvement in the time–frequency analysis of heart rate variability.
 Results. Following treatment with moxonidine, the SBP significant fell from 153.6±8.1 to 130.7±4.6 mmHg (P< 0.001). The DBP also showed a significant reduction from 96.7±2,4 to 80.9±2,6 mmHg (P< 0.001). Reduction
 of SBP pressure was 22.9±7.9 mm Hg and reduction of DBP was 15.9±3.1 mm Hg. 29patients (83%) achieved the goal blood pressure – 130/80 mm Hg and less. 5 patients (14%) were not achieve goal blood pressure, but blood pressure lowered <140/90 mm Hg. In 1 patient (3%) blood pressure decreased from 160/100 mm Hg to 145/90 mm Hg. The majority of patients (28 – 80%)