Pleiotropic effects of moxonidine

Background. Imidazoline receptor agonist moxonidine besides its antihypertensive effect, can increase insulin sensitivity, reduce leptin level, improve lipid metabolism. However, the efficacy, tolerability and pleiotropic effects of moxonidine in postmenopausal women with essential hypertension (EH) and metabolic syndrome (MS) are not well established, and it was the objective of this study. Design and methods. 30 postmenopausal women with EH and MS (52,5 ± 0,4 years old) were included. Moxonidine was administered (400-600 mkg/day) for 12 weeks. Waist circumference (WC), hip circumference (HC), WC/HC ratio, body mass index (BMI), insulin, leptin level, glucose, lipid profile of blood serum, index of insulin resistance (HOMA-IR) and index of functional activity of pancreatic beta cells (HOMA-FB), echocardiography, intima-media thickness (IMT) of common carotid arteries (CCA). Results. Moxonidine therapy was associated with blood pressure (BP) decrease, body weight and BMI decrease, high-density lipoprotein (HDL) cholesterol and HOMA-FB index increase. Left atrium diameter and volume decreased, left ventricular diastolic function improved. Conclusions. Moxonidine is an effective antihypertensive drug for the treatment of postmenopausal hypertensive women with MS, which improves a range of metabolic, hemodynamic parameters and leads to the decrease of left atrium volume and diameter.

moxonidine, insulin resistance, leptin, abdominal obesity, heart remodeling

1. Кириченко А.А. Лечение гипертонической болезни у женщин в постменопаузе // Практикующий врач. - 2003. - № 1. - С. 5-10.

2.

3. De Michele M., Panico S., Iannuzzi A. et al. Association of obesity and central fat distribution with carotid artery wall thickening in middleaged women // Stroke. - 2002. - Vol. 33, № 12. - P. 2923-2928.

4.

5. Haenni A., Lithell H. Moxonidine improves insulin sensitivity in insulin-resistant hypertensives // J. Hypertens. - 1999. - Vol. 17 (Suppl. 3). - P. S29-S35.

6.

7. Sanjuliani A.F., Francischetti E.A., Genelhu de Abreu V. et al. Effects of moxonidine on the sympathetic nervous system, blood pressure, plasma renin activity, plasma aldosterone, leptin, and metabolic profile in obese hypertensive patients // J. Clin. Basic Cardiol. - 2004. - Vol. 7, № 1-4. - P. 19-25.

8.

9. Sharma A.M ., Wagner T., Marsalek P. Moxonidine in the treatment of overweight and obese patients with the metabolic syndrome: a postmarketing surveillance study // J. Hum. Hypertens. - 2004. - Vol. 18, № 9. - P. 669-675.

10.

11. Chazova I.E., Almazov V.A., Shlyakhto E.V. Moxonidine improves glycaemic control in mildly hypertensive, overweight patients: a comparison with metformin (ALMAZ) // Diabetes, Obes. Metab. - 2006. - Vol. 8, № 4. - P. 456-465.

12.

13. Sattar N., Wannamethee G., Sarwar N. et al. Leptin and сoronary heart disease, prospective study and systematic review // J. Am. Coll. Cardiol. - 2009. - Vol. 53, № 2. - P. 167-175.

14.

15. Masajtis-Zagajewska A., Majer J., Nowicki M. Effect of moxonidine and amlodipine on serum YKL-40, plasma lipids and insulin sensitivity in insulin-resistant hypertensive patients-a randomized, crossover trial // Hypertens. Res. - 2010. - [Электронный ресурс]. - URL: http://www.ncbi.nlm.nih.gov/sites/entrez

16.

17. Benetos A., Safar M., Rudnichi A. et al. Pulse pressure. A predictor of long-term cardiovascular mortality in a french male population // Hypertension. - 1997. - Vol. 30, № 6. - P. 1410-1415.

18.

19. Чазова И.Е., Мычка В.Б. Метаболический синдром, сахарный диабет 2 типа и артериальная гипертензия // Сердце. - 2003. - T. 2, Прил. 3, № 9. - 102-144.

20.

21. Akasaka Y., Tsunoda M., Ide T. et al. Chronic leptin treatment stimulates lipid oxidation in immortalized and primary mouse skeletal muscle cells // Biochim. Biophys. Acta. - 2009. - Vol. 1791, № 2. - P. 103-109.

22.

23. Татарский Б.А., Казенова Н.В., Серебряков Н.В. Прямой блокатор ренина при лечении пароксизмальной формы фибрилляции предсердий // Артериальная гипертензия. - 2010. - Т. 16, № 1. - С. 74-81.

24.

25. Mancia G., Backer G.D., Dominiczac A. et al. Guidelines for the management of arterial hypertension // Eur. Heart J. - 2007. - Vol. 28, № 12. - P. 1462-1536.

26.