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.
Description:
Cardiology Department, State
University of Medicine and Pharmacy “Nicolae Testemiţanu”, Chişinău, Republic of Moldova