The aspects of lipid and glucose metabolism following hypertension treatment in patients with metabolic syndrome

Abstract

Introduction: The metabolic syndrome is a global public health issue. Using medication that reduces the sympathetic over activity as one of the manifestations of MS, such as cardioselective (3- adrenoblockers of the III generation (Nebivolol) and the selective agonist of the imidazoline receptors subtype 1 (Ii) III generation (Moxonidine) is one of the main directions of pharmacotherapy in hypertensive patients with MS. Purpose and objectives: Highlighting the lipid and glycemic profile modification in hypertensive patients with or without metabolic syndrome after treatment with Nebivolol and Moxonidine. Materials and Methods: The study included 294 hypertensive patients (Hypertension grade I-II as recommended by the European Society of Cardiology, 2007), of which: MS (group I) - 201 patients and without MS (group II) - 93 patients (control group). The diagnosis of MS was based on the WHO recommendations (1998), IDF (2005). In the treatment phase of the study there were included 191 patients: 93 patients administered for 2 months - Nebivolol and 98 patients used Moxonidine. The gathered material was analyzed statistically by the methods of variational and correlational analysis. Results: The group of MS patients had an average age of 49.57 ± 0.81 years (p>0.05) and the group of patients with MS had an average age of 48.86 ± 1.03 (p>0.05). Long-term administration of Nebivolol in the current study significantly reduced total cholesterol, LDL - cholesterol and triglyceride levels in MS patients, while blood glucose levels were not changed. In the patients treated with Moxonidine 0.2 mg x 2 twice/day for two months, the glucose profile was statistically insignificantly changed: 5,18 ± 0 16 mmol/1 (initial stage) vs. 5.08 ± 0.12 mmol/1 (final stage) (p>0.05), but the basal insulinemia at the initial stage of treatment vs. the final stage (2 months): 9.19 ± 0.51 gUI/ml vs. 8.01 ± 0.52 pUI/ml had a significant statistical difference (p<0.05) and the average value of HOM Air at the initial vs. the final stage, with a decrease in the insulin resistance index: 1.98 ± 0.11 vs. 1.62 ± 0.11, had also a significant statistical difference (p<0.05).The analysis of lipid indexes in the whole group and groups of patients with and without MS showed a downward trend for TC, LDL-C, TG, but no changes in HDL-C. Conclusions: In patients with metabolic syndrome Nebivolol did not influence significantly the glucose metabolism and it improved the state of the lipid, while M oxonidine did not significantly affect lipid metabolism, but improved the indexes of the glucose metabolism.