cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLC10.15829/1728-8800-2011-3-40-46cardiovascular-1805Research ArticleАРТЕРИАЛЬНАЯ ГИПЕРТОНИЯARTERIAL HYPERTENSIONАгонист имидазолиновых рецепторов моксонидин в лечении артериальной гипертонии у пациенток с менопаузальным метаболическим синдромомImidazoline receptor agonist moxonidine and arterial hypertension treatment in women with menopausal metabolic syndromeТишинаЕ. В.TishinaE. V.

аспирант отдела cистемных гипертензий

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tishina_kl@mail.ruМычкаВ. Б.MychkaV. B.ЖернаковаЮ. В.ZhernakovaYu. V.ИвановК. П.IvanovK. P.ТолстовС. Н.TolstovS. N.ЧазоваИ. Е.ChazovaI. E.Институт клинической кардиологии им. А.Л.Мясникова ФГУ РКНПК Минздравсоцразвития РоссииA.L. Myasnikov Research Institute of Clinical Cardiology, Russian Cardiology Scientific and Clinical Complex2011200620111034046Copyright © Тишина Е.В., Мычка В.Б., Жернакова Ю.В., Иванов К.П., Толстов С.Н., Чазова И.Е., 20112011Тишина Е.В., Мычка В.Б., Жернакова Ю.В., Иванов К.П., Толстов С.Н., Чазова И.Е.Tishina E.V., Mychka V.B., Zhernakova Y.V., Ivanov K.P., Tolstov S.N., Chazova I.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1805

Цель. Оценить долгосрочную безопасность и эффективность моксонидина (Физиотенз®), назначаемого с целью снижения артериального давления (АД) пациентам с артериальной гипертонией (АГ) и метаболическим синдромом (МС), в т.ч. женщинам с менопаузальным МС (ММС). Материал и методы. В исследование включены 274 пациента, из них 203 женщины (74 %) и 70 мужчин (26 %). Среди женщин, включенных в исследование, в отдельную группу (гр.) были выделены пациентки с менопаузой. До включения в исследование и через 24 нед терапии моксонидином пациентам проводилась оценка уровня систолического и диастолического АД (САД и ДАД), показателей липидного и углеводного обменов, антропометрических данных. Результаты. На фоне терапии моксонидином эффективно снижалось как САД, так и ДАД, отмечалась положительная динамика таких показателей как гликемия натощак, общий холестерин, липопротеины низкой плотности, липопротеины высокой плотности, триглицериды. Динамика изменения исследуемых показателей у женщин в менопаузе соответствовала таковой в общей гр больных. Заключение. Моксонидин у пациентов с МС позитивно влияет на суточный профиль АД и уровень показателей углеводного и липидного обменов у пациенток с ММС.

Aim. To assess the long-term effectiveness and safety of moxonidine (Physiotens®), as antihypertensive treatment in patients with metabolic syndrome (MS), including women with menopausal MS. Material and methods. The study included 274 patients: 203 women (74 %) and 70 men (26 %). Postmenopausal women comprised a separate study subgroup. At baseline and after 24 weeks of moxonidine treatment, all participants underwent anthropometry and the measurement of systolic and diastolic blood pressure (SBP, DBP), lipid and carbohydrate metabolism parameters. Results. Moxonidine therapy was associated with a reduction in SBP and DBP levels. A positive dynamics in the levels of fasting glucose, total cholesterol, low and high-density lipoproteins (LDL, HDL), and triglycerides was observed. The changes in these parameters were similar among postmenopausal women and all study participants. Conclusion. In MS patients, moxonidine improved circadian BP profile, and also demonstrated beneficial effects on carbohydrate and lipid metabolism parameters in women with menopausal MS.

метаболический синдромартериальная гипертонияменопаузамоксонидинMetabolic syndromearterial hypertensionmenopausemoxonidineReferencesStramba-Badiale Me, Fox KM, Priori SG, et al. Cardiovascular diseases in women: a statement from the policy conference of the European Society of Cardiology. Eur Heart J 2006;27: 994-1005.Stramba-Badiale Me, Fox KM, Priori SG, et al. Cardiovascular diseases in women: a statement from the policy conference of the European Society of Cardiology. Eur Heart J 2006;27: 994-1005.Pyorala K, Lehto S, De Bacquer D, et al. EUROASPIRE I Group; EUROASPIRE II Group. Risk factor management in diabetic and non-diabetic patients with coronary heart disease. Findings from the EUROASPIRE I AND II surveys. Diabetologia 2004; 47: 1257-65.Pyorala K, Lehto S, De Bacquer D, et al. EUROASPIRE I Group; EUROASPIRE II Group. Risk factor management in diabetic and non-diabetic patients with coronary heart disease. Findings from the EUROASPIRE I AND II surveys. Diabetologia 2004; 47: 1257-65.Guthrie JR, Dennerstein L, Taffe JR, et al. The menopausal transition: a 9-year prospective population-based study. The Melbourne Women’s Midlife Health Project. Climacteric 2004; 7: 375-89.Guthrie JR, Dennerstein L, Taffe JR, et al. The menopausal transition: a 9-year prospective population-based study. The Melbourne Women’s Midlife Health Project. Climacteric 2004; 7: 375-89.Reckelhoff JF. Basic research into the mechanisms responsible for postmenopausal hypertension. Int J Clin Pract 2004;58 (Suppl 139):13-9.Reckelhoff JF. Basic research into the mechanisms responsible for postmenopausal hypertension. Int J Clin Pract 2004;58 (Suppl 139):13-9.Meneton PG, Warnock D. Involvement of renal apical Na transport systems in the control of blood pressure. Am J Kidney Dis 2001; 37 (1 suppl 2): 39-47.Meneton PG, Warnock D. Involvement of renal apical Na transport systems in the control of blood pressure. Am J Kidney Dis 2001; 37 (1 suppl 2): 39-47.Khraibi AA. Renal interstitial hydrostatic pressure and sodium excretion in hypertension and pregnancy. J Hypertens Suppl 2002; 20: 21-7.Khraibi AA. Renal interstitial hydrostatic pressure and sodium excretion in hypertension and pregnancy. J Hypertens Suppl 2002; 20: 21-7.Reaven G, Lithell H, Landsberg L. Hypertension and associated metabolic abnormalities — the role of insulin resistance and the sympatoadrenal system. N Engl J Med 1996; 334: 374-81.Reaven G, Lithell H, Landsberg L. Hypertension and associated metabolic abnormalities — the role of insulin resistance and the sympatoadrenal system. N Engl J Med 1996; 334: 374-81.Mendelsohn ME. Genomic and nongenomic effects of estrogen in the vasculature. Am J Cardiol 2002; 90(1 A): 3F-6.Mendelsohn ME. Genomic and nongenomic effects of estrogen in the vasculature. Am J Cardiol 2002; 90(1 A): 3F-6.Ouyang P, Michos ED, Karas RH. Hormone replacement therapy and the cardiovascular system lessons learned and unanswered questions. JACC 2006; 47: 1741-53.Ouyang P, Michos ED, Karas RH. Hormone replacement therapy and the cardiovascular system lessons learned and unanswered questions. JACC 2006; 47: 1741-53.Рекомендации всероссийского научного общества кардиологов по диагностике и лечению артериальной гипертонии 2008г.Рекомендации всероссийского научного общества кардиологов по диагностике и лечению артериальной гипертонии 2008г.Ernsberger P. “The I1-imidazoline receptor and its cellular signaling pathways”. Ann N Y Acad Sci 1999; 881: 35-53.Ernsberger P. “The I1-imidazoline receptor and its cellular signaling pathways”. Ann N Y Acad Sci 1999; 881: 35-53.Ernsberger P. Pharmacology of moxonidine. An I1-imidazoline receptor antagonist. J Cardiovasc Pharmacol 2000; 35: S27-41.Ernsberger P. Pharmacology of moxonidine. An I1-imidazoline receptor antagonist. J Cardiovasc Pharmacol 2000; 35: S27-41.Friedman J. Anti-Hyperglycemic Activity of Moxonidin. Blood Pressure 1998; 7 Suppl 3: 32-9.Friedman J. Anti-Hyperglycemic Activity of Moxonidin. Blood Pressure 1998; 7 Suppl 3: 32-9.Frei M, Kuster L, Gardosh von Krosigh P-P, et al. Moxonidine and hydrochlorothiazide in combination: a synergistic antithypertensive effect. J Cardiovasc Pharmacol 1994; 24 (Suppl 1): S25-8.Frei M, Kuster L, Gardosh von Krosigh P-P, et al. Moxonidine and hydrochlorothiazide in combination: a synergistic antithypertensive effect. J Cardiovasc Pharmacol 1994; 24 (Suppl 1): S25-8.Prichard BNC, Simmons R, Rooks M, et al. A double-blind comparison of moxonidine and atenolol in the management of patiens with mild-to-moderate hypertension. J Cardiovasc Pharmacol 1992, 24 (Suppl 4): S45-9.Prichard BNC, Simmons R, Rooks M, et al. A double-blind comparison of moxonidine and atenolol in the management of patiens with mild-to-moderate hypertension. J Cardiovasc Pharmacol 1992, 24 (Suppl 4): S45-9.Kraft K, Vetter H. Twenty-four-hour blood pressure profiles in patients with mild-to-moderate hypertension: moxonidine versus captopril. J Cardiovasc Pharmacol 1994; 24 (Suppl 1): S29-33.Kraft K, Vetter H. Twenty-four-hour blood pressure profiles in patients with mild-to-moderate hypertension: moxonidine versus captopril. J Cardiovasc Pharmacol 1994; 24 (Suppl 1): S29-33.Kuppers HE. Placebo-controlled comparison of the efficacy and tolerability of once-daily moxonidine and enalapril in mild-tomoderate essential hypertension. J Hypertens 1997; 15: 93-7.Kuppers HE. Placebo-controlled comparison of the efficacy and tolerability of once-daily moxonidine and enalapril in mild-tomoderate essential hypertension. J Hypertens 1997; 15: 93-7.Waters J, Ashford J, Jager B, et al. Use of moxonidine as initial therapy and in combination in the treatment of essential hypertension — results of the TOPIC Study. J Clinical Basic Cardiol 1999; 2: 219-24.Waters J, Ashford J, Jager B, et al. Use of moxonidine as initial therapy and in combination in the treatment of essential hypertension — results of the TOPIC Study. J Clinical Basic Cardiol 1999; 2: 219-24.Чазова И.Е., Мычка В.Б. Новые возможности в лечении больных с метаболическим синдромом. Результаты исследования ALMAZ. Сист гиперт 2006; 8(2): 14-8.Чазова И.Е., Мычка В.Б. Новые возможности в лечении больных с метаболическим синдромом. Результаты исследования ALMAZ. Сист гиперт 2006; 8(2): 14-8.

The authors declare that there are no conflicts of interest present.