Key result
Moxonidine lowers blood pressure and improves metabolic profiles in peri- and postmenopausal women.
Expert consensus highlights the role of hormonal changes and sympathetic overactivity in the pathogenesis of hypertension in peri- and postmenopausal women, discussing antihypertensive management and the metabolic benefits of moxonidine.
May support moxonidine in peri/postmenopausal hypertension; leaves open confirmation in randomized trials.
An important role in the development and evolution of hypertension in females is applied to sex hormones. Estrogen deficiency and hyperandrogenism, characteristic of periand postmenopause, are links in the pathogenesis of hypertension in this period of a woman's life and are accompanied by an increase in sympathetic nervous system activity, renin-angiotensin-aldosterone system activation, salt sensitivity, abdominal obesity and metabolic syndrome, left ventricle hypertrophy, left atrial dilatation with a high risk of atrial fibrillation, stroke and heart failure development. The paper discusses antihypertensive therapy during periand postmenopause, effectiveness and tolerability of different drug classes. Special attention is paid to the mechanism of action of selective I1-imidazoline receptor agonist moxonidine, which in women during this period both effectively reduces high blood pressure and has a beneficial metabolic effect, what is documents in studies of monotherapy, combined antihypertensive therapy with major classes and in combination with menopausal hormone therapy. The paper presents the joint expert opinion concerning above mentioned issues.
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Polyakova et al. (2023) conducted a review in Hypertension in peri- and postmenopausal women. Antihypertensive therapy (including Moxonidine) was evaluated. Estrogen deficiency and hyperandrogenism in peri- and postmenopausal women contribute to the pathogenesis of hypertension, with moxonidine highlighted as an effective antihypertensive treatment offering beneficial metabolic effects.
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