The effect of moxonidine on endothelial dysfunction in metabolic syndrome.
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.


CONCLUSIONS
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.
Topal
Ergun
E
Department of Cardiology, Inonu University Faculty of Medicine, Malatya, Turkey.
Cikim
Ayse Sertkaya
AS
Cikim
Kerim
K
Temel
Ismail
I
Ozdemir
Ramazan
R
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001795:Blood Pressure Determination; D031204:Caloric Restriction; D003131:Combined Modality Therapy; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy*; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000178:diet therapy / Q000188:drug therapy; D013997:Time Factors; D016896:Treatment Outcome; D049629:Waist-Hip Ratio; D005723:gamma-Glutamyltransferase / Q000097:blood
D000959:Antihypertensive Agents; D007093:Imidazoles; C043482:moxonidine; D005723:gamma-Glutamyltransferase