The role of hypersympathycotony in development of arterial hypertensionin patients with metabolic syndrome: potential of pathogenetically sound therapy

Abstract

Aim. To assess hypotensive efficacy and metabolic neutrality of moxonidine (physiotenz) - a selective agonist of imidasoline receptors - in patients with mild and moderate arterial hypertension (AH) associated with diabetes mellitus (DM) type 2. Material and methods. Follow-up and treatment were conducted in 30 hypertensive diabetics (mean age 52.43 ± 4.65 years). Mean duration of DM and AH was 4.77 ± 2.69 and 6.93 ± 2.98 years, respectively. The study was made of lipid exchange, glycemia, levels of glycosylated hemoglobin (GH), fasting and postprandial immunoreactive insulin. Hypotensive efficacy was examined by 24-h monitoring of arterial pressure after 16 weeks of therapy. Results. Mean 24-h systolic arterial pressure fell by 8.02%, diastolic arterial pressure - by 6.47%. The drug had a good effect on a 24-h profile of arterial pressure: a significant decrease of day and night pressure load index, lowering of initially high 24-h variability of systolic and diastolic arterial pressure, normalization of two-phase profile of arterial pressure. Carbohydrate metabolism improved also: GH, glycemia, immunoreactive insulin decreased. There was a significant trend to a change in qualitative composition of blood lipids - a decrease in lipoproteins atherogenic fractions and a rise in HDLP. Conclusion. Physiotens is a highly effective hypotensive drug for use in mild and moderate AH in DM of type 2.

Keywords

• hypersympathycotonia
• metabolic syndrome
• insulinoresistense
• arterial hypertension
• diabetes mellitus type 2
• moxonidine