COMPARATIVE EVALUATION OF THERAPEUTIC EFFECT OF MOXONIDINE VERSUS AMLODIPINE ON BLOOD PRESSURE IN OBESE HYPERTENSIVES

Abstract

Background: High blood pressure is frequently associated with metabolic alterations such as insulin resistance, impaired glucose tolerance, dyslipidaemia and obesity. Moxonidine, a selective imidazoline receptor agonist, reduces activity of sympathetic nervous system and lowers blood pressure, and has been shown to have benecial effects on lipid and carbohydrate metabolism. The present study has been conducted to evaluate antihypertensive efcacy of moxonidine and compare it with amlodipine in mild to moderate hypertension in obese patients. Methods: This was an open-label randomized study. Patients were divided into two groups of 50 patients each, rst group was given amlodipine 5 mg daily and the second group was given moxonidine 0.2 mg once daily. At the end of 8 weeks, the therapeutic effects of both regimes on blood pressure in obese patients with stage 1 and stage 2 hypertension were compared and also with lipid prole, fasting sugars and microalbuminuria. Results: The study involved 100 participants with a mean age of 51.12±6.25 years and 48.88±5.15 years in moxonidine group and amlodipine group, respectively. Systolic and diastolic blood pressure reduction was signicant in both groups at 8-weeks (p<0.001). The reduction in FBS (p=0.008), total cholesterol (p=0.04), serum triglycerides (p<0.001) and increase in HDL (p=0.02) were all signicant in moxonidine group, but LDL reduction was not signicant. In amlodipine group, change in FBS, total cholesterol, serum triglycerides, HDL and LDL levels were all insignicant. There was also signicant reduction in microalbuminuria in moxonidine group. Conclusion: Moxonidine and amlodipine are equally effective antihypertensives and safe in obese hypertensives. Moxondine has additional favourable effects on lipid prole (serum cholesterol, TGs and LDL), fasting blood glucose and microalbuminuria.