Pharmacotherapy efficacy assessment in arterial hypertension with metabolic disturbances

Abstract

Aim. To assess efficacy of various pharmacotherapy schemes in arterial hypertension (AH) with metabolic disturbances (MD).
Material and methods. Open, randomized, comparative study in 3 parallel groups, including 90 patients with Stage I-II AH and MD, was performed. Group 1 was administered moxonidine and eprosartan; Groups 2 and 3 – standard monotherapy (diuretic, beta blocker, calcium antagonist, plus ACE inhibitor in case of low effectiveness); Group 3 additionally received a lipase inhibitor orlistat.
Results. Eight weeks later, target BP level was achieved in 86% patients from Group 1, 73% – from Group 2, and 57% - from Group 3. In Group 3, body mass index decreased by 5.3%, and waist circumference – by 3.5%. Total cholesterol level reduced in Groups 1 (by 7.3%) and 3 (by 9.6%). In Group 1, basal immunoactive insulin level declined by 25.2%. Fasting glycemia reduced in Groups 1 and 3 – by 6.3% and 8.6%, respectively. In Group 1, basal cortisol level decreased by 26.3%. All medications were well tolerated.
Conclusion. Imidazoline receptor antagonist was more effective than standard therapy: despite compatible antihypertensive effects, moxonidine improved metabolic parameters. Adding orlistat to antihypertensive treatment improved metabolic parameters and 24-hour BP profile in patients with AH and MS.