Efficacy of moxonidine in the treatment of hypertension in obese, noncontrolled hypertensive patients.
BACKGROUND
Obesity has become an epidemic problem, contributing to metabolic syndrome, type 2 diabetes, hypertension, and cardiovascular disease. An adequate blood pressure control in this population of obese individuals is extremely difficult to achieve, and in most cases, therapeutic combinations are required. Pharmacologic treatment with moxonidine, a central I(1) imidazole receptor agonist, is a very interesting option because it acts upon the mechanisms implicated in the development of arterial hypertension in these patients. In addition, the drug improves the peripheral insulin resistance often found in obese patents, which contributes to maintain high blood pressure.


METHODS
An interventional study has been designed, adding moxonidine to noncontrolled hypertensive, obese subjects in whom a hypocaloric diet was previously recommended. A total of 25 primary care centers participated in the study, with a total of 135 patients recruited.


RESULTS
One hundred twelve patients were included in the study; 25 of them had type 2 diabetes. The mean reduction in systolic and diastolic blood pressure after 6 months treatment with moxonidine was 23.0 and 12.9 mm Hg, respectively. The mean systolic and diastolic pressures were 158.5 +/- 10.6 and 95.1 +/- 9 mm Hg, respectively, at baseline, versus 135.5 +/- 11.6 and 82.2 +/- 5.8 mm Hg at the end of the study. Creatinine clearance was significantly decreased in hyperfiltrating obese patients (143.6 +/- 31 vs. 128.2 +/- 27.9, P < 0.0001), without any significant change in patients with normal or slightly decreased renal function (81.9 +/- 18.9 vs. 80.9 +/- 17.5). Only 8 mild adverse reactions in 7 patients were recorded during the study.


CONCLUSIONS
Moxonidine is useful and safe for controlling arterial hypertension in obese patients.
Abellán
José
J
Cátedra de Riesgo Cardiovascular, Universidad Católica de Murcia, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Leal
Mariano
M
Hernández-Menárguez
Fernando
F
García-Galbis
José A
JA
Martínez-Pastor
Antonio
A
de Vinuesa
Soledad Garcia
SG
Luño
José
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D007333:Insulin Resistance; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*
D000959:Antihypertensive Agents; D007093:Imidazoles; C043482:moxonidine