The effect of moxonidine on endothelial dysfunction in metabolic syndrome.

Abstract

BACKGROUND:

Endothelial dysfunction has been reported in patients with type 2 diabetes mellitus and even in healthy obese individuals with a normal metabolic profile. Sympathetic activity commonly is increased in obese hypertensive patients, and moxonidine is effective in lowering BP and improving insulin sensitivity.

OBJECTIVE:

To evaluate the effect of moxonidine on endothelial dysfunction in patients with metabolic syndrome.

METHODS:

Twenty-six patients with mild hypertension were treated with moxonidine and a hypocaloric diet for 3 months, while a second normotensive group (n = 26) were followed-up with calorie restriction alone. Anthropometric (body mass index, waist and hip circumferences, and waist-to-hip ratio) and metabolic features (fasting plasma glucose and insulin, aminotransferases, gamma-glutamyl transpeptidase, triglycerides, and cholesterol levels) and flow-mediated dilatation (FMD) were evaluated. Insulin resistance was calculated by using the homeostasis model assessment formula. Insulin sensitivity was calculated according to the quantitative insulin-sensitivity check index (QUICKI).

RESULTS:

SBP and DBP (both p < 0.001) and waist circumference (p = 0.02) were higher, and QUICKI (p = 0.043) and FMD (p = 0.01) were lower in the hypertensive group at baseline. After 3 months, nearly all the study parameters improved in both treatment groups. The decrease in BP, increase in FMD, and improvements in metabolic and anthropometric parameters were significantly greater in the moxonidine-treated group than in those treated with diet alone.

CONCLUSION:

Moxonidine is proposed as a valuable option for treating mild-to-moderate hypertension in obese and insulin-resistant patients with metabolic syndrome as it appears to improve endothelial dysfunction in these patients.

• Authors: Ergun Topal, Ayse Sertkaya Cikim, Kerim Cikim, Ismail Temel, Ramazan Ozdemir
• Journal: American journal of cardiovascular drugs : drugs, devices, and other interventions (Am J Cardiovasc Drugs) Vol. 6 Issue 5 Pg. 343-8 ( 2006) ISSN: 1175-3277 [Print] New Zealand
• PMID: 17083269 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Antihypertensive Agents
• Imidazoles
• moxonidine
• gamma-Glutamyltransferase

Topics

• Adult
• Antihypertensive Agents (therapeutic use)
• Blood Pressure Determination
• Caloric Restriction
• Combined Modality Therapy
• Endothelium, Vascular (drug effects, physiopathology)
• Female
• Humans
• Hypertension (complications, diet therapy, drug therapy)
• Imidazoles (therapeutic use)
• Male
• Metabolic Syndrome (complications, diet therapy, drug therapy)
• Middle Aged
• Obesity (complications, diet therapy, drug therapy)
• Time Factors
• Treatment Outcome
• Waist-Hip Ratio
• gamma-Glutamyltransferase (blood)