Document Detail


Use of moxonidine in elderly patients with resistant hypertension.
MedLine Citation:
PMID:  16164488     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Treatment of hypertension in the elderly people reduces the risk of cardiovascular and cerebrovascular events. Effective treatment often will require the use of two or more antihypertensive agents. Elderly people are at increased risk of adverse events from medication because of physiological changes in pharmacokinetics and pharmacodynamics, polypharmacy and drug interactions. They might not tolerate conventional add-on regimens of antihypertensives as a result. OBJECTIVE: To investigate the use of the I1-imidazoline receptor agonist moxonidine as an 'add-on' agent in elderly patients with resistant hypertension. METHODS: We investigated the safety and efficacy of moxonidine (200-400 microg) in a group of elderly patients whose blood pressure (BP) control remained poor despite treatment with two or more antihypertensives. BP was assessed by ambulatory BP monitoring with Spacelabs oscillometric equipment (Model 90207) before and after 6 weeks of treatment with moxonidine used as an 'add-on' agent with the patients normal medication. RESULTS: Following treatment with moxonidine, the mean daytime systolic BP fell from 169.2 to 153.8 mmHg, a significant reduction of 15.4 +/- 8.9 mmHg (P = 0.003). The mean daytime diastolic BP fell from 91.6 to 84.2 mmHg, a reduction of 7.4 +/- 5.8 mmHg (P = 0.017). For the night-time readings, the systolic BP fell from 151.1 to 141.2 mmHg, a reduction of 9.3 +/- 9.3 mmHg (P = 0.05). The corresponding diastolic fall in BP was not significant (77.9-74.7 mmHg). The 24 h-readings showed a significant reduction in the mean systolic BP from 163.0 to 148.6 mmHg (P = 0.004). The mean diastolic BP also fell significantly from 87.2 to 80.2 mmHg (P = 0.013). Clinical BP readings also showed a significant reduction from 195.9 +/- 19.6 to 174 +/- 17.8 mmHg (P = 0.002) and 103.6 +/- 9.5 to 99.0 +/- 12.4 mmHg (P = 0.013) for systolic and diastolic readings respectively. Moxonidine was well tolerated in 11 of the14 patients. CONCLUSION: These results suggest that moxonidine might have a place as an 'add-on' treatment in elderly patients whose hypertension is poorly controlled despite treatment with two or more antihypertensive agents.
Authors:
U Martin; C Hill; D O' Mahony
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical pharmacy and therapeutics     Volume:  30     ISSN:  0269-4727     ISO Abbreviation:  J Clin Pharm Ther     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-16     Completed Date:  2005-12-07     Revised Date:  2008-05-28    
Medline Journal Info:
Nlm Unique ID:  8704308     Medline TA:  J Clin Pharm Ther     Country:  England    
Other Details:
Languages:  eng     Pagination:  433-7     Citation Subset:  IM    
Affiliation:
Division of Medical Sciences, University of Birmingham, Edgbaston, Birmingham, UK. u.martin@bham.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Aged*
Aged, 80 and over
Antihypertensive Agents / therapeutic use*
Blood Pressure / drug effects
Circadian Rhythm / physiology
Drug Resistance
Drug Therapy, Combination
Female
Heart Rate / drug effects
Humans
Hypertension / drug therapy*
Imidazoles / therapeutic use*
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 0/Imidazoles; 75438-57-2/moxonidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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