Randomized comparative study of the moxonidine effectiveness in patients with uncomplicated hypertensive crisis. (AVES)

Abstract

Objective. Evaluate the clinical efficacy and safety of moxonidine selective inhibitor of imidazoline I1-receptors, compared with angiotensin-converting enzyme inhibitor captopril in patients with uncomplicated hypertensive crisis (UHC). Material and Methods used in Study.The Study has been conducted on 225 patients (125 female and 100 male), average age 56.2±14.4 with uncomplicated hypertensive crisis (UHC). All patients were randomly divided into two groups: patients in moxonidine group (n=113) received a single dose of 0.4 mg moxonidine orally and patients in captopril group (n=112) received a single dose of 25 mg captopril. Along with general clinical tests, the following tests were conducted: dynamic measurement of blood pressure (BP), heart rate, electrocardiogram, creatinine, potassium and glucose levels in blood. Performance indicators for patients were the time of onset of antihypertensive effect, blood pressure level and duration of antihypertensive effect. To evaluate each medicament effectiveness, the blood pressure monitoring has been performed daily. Output dynamics were analyzed for 12 hours. Results. Anti-hypertensive effect, expressed in terms of a significant reduction in systolic blood pressure in both groups, has been reached after 30 minutes, significant reduction in diastolic blood pressure - after 60 minutes, following the administration of drugs. Level of BP reduction did not exceed 25% of the baseline. Moxonidine advantage was detected primarily in the course of anti-hypertensive action with sustained drop in blood pressure over the entire period of observation. The favorable metabolic effects of moxonidine were confirmed. In particular, its effects were manifested in significant reduction of serum creatinine. When compared, in moxonidine group 26.9% more of the patients were with efficiency above satisfactory, tolerance above satisfactory - 18.8% more than in captoril group.Conclusions. The results show a higher level of moxonidine efficacy and a good degree of tolerability in comparison with captopril in patients with uncomplicated hypertensive crises. The drug can be successfully used for treatment of uncomplicated hypertensive crises, starting in the phase prior to admission to hospital, especially in patients with concomitant illnesses (diabetes, metabolic syndrome, chronic renal failure).