Original Research Article

American Journal of Cardiovascular Drugs

, Volume 6, Issue 5, pp 343-348

First online:

The Effect of Moxonidine on Endothelial Dysfunction in Metabolic Syndrome

  • Ergun TopalAffiliated withDepartment of Cardiology, Inonu University Faculty of Medicine
  • , Ayse Sertkaya CikimAffiliated withDepartment of Internal Medicine, Division of Endocrinology and Metabolism, Inonu University Faculty of Medicine Email author 
  • , Kerim CikimAffiliated withDepartment of Internal Medicine, Inonu University Faculty of Medicine
  • , Ismail TemelAffiliated withDepartment of Biochemistry, Inonu University Faculty of Medicine
  • , Ramazan OzdemirAffiliated withDepartment of Cardiology, Inonu University Faculty of Medicine

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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, γ-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.