Pöyhönen-Alho Maritta K, Manhem Karin, Katzman Per, Kibarskis Aleksandras, Antikainen Riitta L, Erkkola Risto U, Tuomilehto Jaakko O, Ebeling Pertti E, Kaaja Risto J
Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland.
J Hypertens. 2008 Dec;26(12):2445-9. doi: 10.1097/HJH.0b013e328311cf37.
Postmenopausal phase expresses many unfavourable physiological changes that lead to increased risk for cardiovascular disease. We compared the effect of two sympatholytic antihypertensive drug treatments, the centrally acting imidazoline receptor-1 agonist moxonidine and peripherally acting beta-blocking agent atenolol on sensitive inflammatory markers in overweight postmenopausal women with diastolic hypertension.
This was a multicentre, multinational double-blinded, prospective study comparing moxonidine (0.3 mg twice daily) with atenolol (50 mg once daily) in 87 hypertensive postmenopausal overweight women who were not taking hormone therapy. Sensitive C-reactive protein, IL-6, TNFalpha, TNFalpha-RII and adiponectin were determined in the beginning of the study and after 8 weeks of medical treatment.
TNFalpha increased in atenolol and decreased in moxonidine group (P = 0.0004 between the groups). Adiponectin concentration decreased dramatically in atenonol but did not change in moxonidine treatment group (P < 0.0001 between the groups). In logistic regression analysis only treatment group showed an independent effect on changes in adiponectin and TNFalpha concentrations.
We believe that centrally acting sympatholytic agent moxonidine is beneficial in the treatment of postmenopausal women with hypertension by reducing inflammatory cytokine TNFalpha without changing protective adiponectin level.
绝经后阶段会出现许多不利的生理变化，导致心血管疾病风险增加。我们比较了两种抗交感神经降压药物治疗，即中枢作用的咪唑啉受体-1激动剂莫索尼定和外周作用的β受体阻滞剂阿替洛尔，对超重绝经后舒张期高血压女性敏感炎症标志物的影响。
这是一项多中心、跨国双盲前瞻性研究，在87名未接受激素治疗的高血压绝经后超重女性中，将莫索尼定（每日两次，每次0.3毫克）与阿替洛尔（每日一次，每次50毫克）进行比较。在研究开始时和药物治疗8周后，测定敏感C反应蛋白、白细胞介素-6、肿瘤坏死因子α、肿瘤坏死因子α受体II和脂联素。
阿替洛尔组肿瘤坏死因子α升高，莫索尼定组降低（两组间P = 0.0004）。阿替洛尔组脂联素浓度显著降低，而莫索尼定治疗组未改变（两组间P < 0.0001）。在逻辑回归分析中，只有治疗组对脂联素和肿瘤坏死因子α浓度的变化显示出独立影响。
我们认为，中枢作用的抗交感神经药物莫索尼定通过降低炎症细胞因子肿瘤坏死因子α而不改变保护性脂联素水平，对绝经后高血压女性的治疗有益。
