Krupicka J, Soucek M, Chroust K
Kardiologická ambulance Brandýs nad Labem.
Vnitr Lek. 2011 Jun;57(6):541-5.
Treatment with agents neutral to lipid metabolism but with a positive effect on glucose metabolism might significantly improve the long-term prognosis of patients with metabolic syndrome and hypertension. The aim of our non-interventional observational clinical study was to evaluate the safety of treatment with moxonidine and to assess changes to the metabolic syndrome-related laboratory parameters.
A total of 748 patients over 18 years of age (22-87; mean 59; median 60) were included in a 6-month evaluation (two 3-monthly study visits). There were slightly more female patients (n = 401, 54%) with metabolic syndrome (> or = 3 NCE ATP III risk factors) and poorly controlled hypertension. A standardized data collection form was used, blood pressure measurement was standardized as per the guidelines and laboratory samples were assessed in a certified laboratory. The study medication (moxonidine, Cynt) was prescribed to patients with newly diagnosed hypertension and/or patients with hypertension poorly controlled at an initial visit.
The majority of patients (98.8%) completed the study. No adverse effects were reported during the study. Moxonidine was mostly prescribed as an add-on treatment to other antihypertensives (81.1% patients) due to the lack of efficacy of the present antihypertensive treatment. The most frequent dose was 0.4 mg/day as monotherapy (44.9% of patients) as well as add on treatment (59.8% of patients). A change to the treatment was performed in 142 (19.2%) of patients during the follow up visit and in 57 (7.7%) of patients during the last study visit. All parameters (blood pressure, body weight, waist circumference, total cholesterol, LDL- and HDL-cholesterol, triglycerides, glycaemia and pulse) have changed highly significantly (p < 0.001).
Over the 6-month follow up, a highly significant change was observed to all monitored parameters. An addition of monoxidine (Cynt) to an existing treatment resulted not only in a reduction to blood pressure but also in highly significant changes to metabolic parameters without any significant modifications of the treatment. Treatment with monoxidine can be considered as metabolically neutral with an added value of positive effect on metabolic parameters. This is in line with the results of other studies.
使用对脂质代谢呈中性但对糖代谢有积极作用的药物进行治疗，可能会显著改善代谢综合征和高血压患者的长期预后。我们这项非干预性观察性临床研究的目的是评估莫索尼定治疗的安全性，并评估与代谢综合征相关的实验室参数的变化。
共有748名18岁以上的患者（年龄在22 - 87岁之间；平均年龄59岁；中位数60岁）纳入为期6个月的评估（每3个月进行两次研究访视）。患有代谢综合征（≥3项美国国家胆固醇教育计划成人治疗组第三次报告风险因素）且高血压控制不佳的女性患者略多（n = 401，54%）。使用标准化的数据收集表，血压测量按照指南进行标准化，实验室样本在一家认证实验室进行评估。研究药物（莫索尼定，Cynt）被开给新诊断为高血压的患者和/或初次就诊时高血压控制不佳的患者。
大多数患者（98.8%）完成了研究。研究期间未报告不良反应。由于当前抗高血压治疗缺乏疗效，莫索尼定大多作为其他抗高血压药物的附加治疗（81.1%的患者）。最常用的剂量是每日0.4毫克，作为单药治疗（44.9%的患者）以及附加治疗（59.8%的患者）。在随访期间，142名（19.2%）患者的治疗方案发生了改变，在最后一次研究访视期间，57名（7.7%）患者的治疗方案发生了改变。所有参数（血压、体重、腰围、总胆固醇、低密度脂蛋白和高密度脂蛋白胆固醇、甘油三酯、血糖和脉搏）都有极显著变化（p < 0.001）。
在6个月的随访中，观察到所有监测参数都有极显著变化。在现有治疗方案中添加莫索尼定（Cynt）不仅能降低血压，还能使代谢参数发生极显著变化，且治疗方案无任何显著改变。莫索尼定治疗可被视为代谢中性，对代谢参数有积极的附加价值。这与其他研究结果一致。
