Moxonidine in treatment of arterial hypertension in patients with metabolic syndrome

Abstract

Purpose. To evaluate the efficacy of moxonidine, an imidazoline receptor agonist, in patients with arterial hypertension (AH) and metabolic syndrome compared to enalapril, an ACE inhibitor. Materials and methods. The complex study included 50 patients with AH and metabolic syndrome. Inclusion criteria were abdominal obesity (waist-to-hip ratio (WHR) exceeded 0.95 in men and exceeded 0.80 in women, with BMI ≥25 kg/m 2 , AH of 1st - 2-nd degrees, type 2 diabetes mellitus (DM) in the stage of compensation, dyslipidemia. The mean age of patients was 52 years, duration of AH is 11 years, duration of type 2 DM is 7 years. After examination under conditions of a pure background and obtaining of DM compensation, all patients with AH and metabolic syndrome were randomized into 2 groups. The first group of patients (25 people) received moxonidine, an imidazoline receptor agonist, in individually selected dose of 0.2-0.6 mg per day, an average daily dose of 0.4 mg in twice a day form. The second group (25 people) took enalapril, an ACE inhibitor, in a dose of 5-15 mg per day, an average dose of 10 mg, respectively. A control study was performed after 4 weeks. Results. In patients with AH and metabolic syndrome, the use of moxonidine and enalapril for the correction of blood pressure (BP) showed a comparable effect in changes of office BP, average 24-hour BP, average day-time and night-time BP with the same frequency of achieving target BP. However, only moxonidine showed additional positive effect on the increased BP variability, contributed to the normalization of 24-hour BP profile, reducing the morning rise in BP, reduced the frequency of heart rate and the value of the double product. Moreover, moxonidine had cerebroprotective effects, increasing the cerebrovascular reactivity index. Conclusion. In hypertensive patients with metabolic syndrome, moxonidine provides the best prevention of cardiovascular complications.