A therapeutic approach to treating arterial hypertension in patients with insulin resistance
https://doi.org/10.14341/probl20065255-11
Abstract
The purpose of the study was to evaluate moxonidme therapy on the daily profde of blood pressure (BP), insulin sensitivity, glucose tolerance, carbohydrate and lipid metabolic parameters, and vascular endothelial function in patients with metabolic syndrome (MS) and grade 1 arterial hypertension (AH). The study included 20 patients (8 males and 12 females) aged 44.85±5.87 years, who had MS and grade 1 AH. All the patients took moxonidine in a dose of 0.2 mg twice daily. Body weight and waist and hip circumferences were measured, a biochemical blood study (lipid profile, glucose, uric acid, liver tests) and oral glucose tolerance lest determining endogenous insulin and C-peplide were performed, leptin and blood vasoactive hormones were estimated, and office BP measurement and 24-hour BP monitoring were made at baseline and after 12-week therapy. Target BP could be achieved in 90% of the patients. After therapy, there were significant body weight losses, improved daily BP profile, increased glycemic index, and better lipid profile. In addition, moxonidine therapy caused significant decreases in vasoconstrictive hormones and leptin and an elevation in nitric oxide levels. Along with antihypertensive activity, moxonidine exerts a positive effect on insulin sensitivity, lipid metabolism, and endothelial function in patients with MS and AH.
About the Authors
V В Mychka
Институт клинической кардиологии им. А. Л. Мясникова Российского кардиологического научно-производственного комплекса Минздравсоцразвития РФ
V P Masenko
Институт клинической кардиологии им. А. Л. Мясникова Российского кардиологического научно-производственного комплекса Минздравсоцразвития РФ
I Ye Chazova
Институт клинической кардиологии им. А. Л. Мясникова Российского кардиологического научно-производственного комплекса Минздравсоцразвития РФ
References
1. Алмазов В. А., Благосклонная Я. В., Шпяхто Е. В. и др. // Тер. арх. - 1999. - № 10. - С. 20-24.
2. Соколова Л. А, Русанов О. А., Винник Т. А. и др. // Артериальная гипертензия. - 2000. - Т. 6, № 1. - С. 59-62.
3. Чазова И. Е., Мычка В. Б. Метаболический синдром. - М., 2004.
4. Betterldge D. J. Risk Management with Moxonidine: Focus on ALMAZ and other Trials in Insulin Resistance. - ESC 2004.
5. Celermajer D. S., Sorensen K. E., Gooch V. M. et al. // Lancet. -1992. - Vol. 340. - P. 1111-1115.
6. Ernsberger P., Damon T. H., Graff L. M. et al. // J. Pharmacol. Exp. Then - 1993. - Vol. 624. - P. 172-192.
7. Ernsberger P., Ishizuka Т., Liu S. et al. // J. Pharmacol. Exp. Then - 1999. - Vol. 288. - P. 139-147.
8. Frel M., Kuster L., Gardosh von Krosigh P.-P, Koch H. F. // J. Cardiovasc. Pharmacol. - 1994. - Vol. 24. - Suppl. 1. - P. S25-S28.
9. Freldman J. E., Ishizuka Т., Liu S. // Blood Pressure. - 1998. -Vol. 7. - Suppl. 3. - P. 32-39.
10. Haennl A., Lllhell H. // J. Hypertens. - 1999. - Vol. 17. -Suppl. 3. - P. S29-S39.
11. Julius S., Gudbrandsson Т., Jamerson K. et al. // J. Hypertens. -1991. - Vol. 9. - P. 983-986.
12. Kraft K, Vetier H. // J. Cardiovasc. Pharmacol. - 1994. - Vol. 24. - Suppl. 1. - P. S29-S33.
13. Kuppers H. E. et al. // J. Hypertens. - 1997. - Vol. 15. -P. 93-97.
14. Likungu J, Molderings G. L., Gothert M. // Nauyn-Schmiede-bergs Arch. Pharmacol. - 1996. - Vol. 354. - P. 689-692.
15. Llthell H. // Report from Satellite // Symposium of XIX Congress of European Society of Cardiology. - Stockholm, 1997. -P. 1-8.
16. Mitrovic V. et al. // Cardiovasc. Drug Ther. - 1991. - Vol. 5. -P. 967-972.
17. Prichard B. N. C, Simmons R., Rooks M. et al. // J. Cardiovasc. Pharmacol. - 1992. - Vol. 24. - Suppl. 4. - P. S45- S49.
18. Reaven G. M., Lithel H., Landsberg L. // N. Engl. J. Med. - 1996. - Vol. 334. - P. 374-381.
19. Rosen P., Ohly P., Gleichman H. // J. Hypertens. - 1997. - Vol. 15. - Suppl. - P. S31-S38.
20. Sanjulianl A. F., Genelhu de Abreu V., Ueleres Braga J. et al. // J. Clin. Basic Cardiol. - 2004. - Vol. 7, N 1-4. - P. 19-25.
21. Sharma A. M., Wagner Т., Marsalek P. // 1. Hum. Hypertens. -2004. - Vol. 18, N 9. - P. 669-675.
22. Zwieten P. A. // J. Hypertens. - 1997. - Vol. 15. - P. 117-125.
23. Waters J., Ashford J., Jager B. et al. // J. Clin. Basic Cardiol. -1999. - Vol. 2. - P. 219-224.
24. Wimann H.-J., Rudolph M. // J. Cardiovacs. Pharmacol. - 1992. - Vol. 20. - P. S37-S41.
25. Wolf R. // J. Cardiovasc. Pharmacol. - 1992. - Vol. 20. -Suppl. 4. - P. S42-S44.
Review
For citations:
Mychka V.В., Masenko V.P., Chazova I.Ye. A therapeutic approach to treating arterial hypertension in patients with insulin resistance. Problems of Endocrinology. 2006;52(5):5-11. (In Russ.) https://doi.org/10.14341/probl20065255-11
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