Key result
Moxonidine and amlodipine equally reduced blood pressure in obese hypertensives at 8 weeks (p<0.001), while moxonidine additionally improved fasting sugars, lipids, and microalbuminuria.
Why the study?
Hypertension is frequently linked to metabolic alterations, and moxonidine reduces sympathetic activity, lowers blood pressure, and benefits lipid and carbohydrate metabolism, prompting an evaluation of its antihypertensive efficacy compared to amlodipine in obese patients with mild to moderate hypertension.
Does moxonidine improve blood pressure and metabolic parameters compared to amlodipine in obese hypertensives?
RCT (n=100)
Open-label
randomized
Does moxonidine improve blood pressure and metabolic parameters compared to amlodipine in obese hypertensives?
In obese hypertensives, moxonidine is as effective as amlodipine for blood pressure reduction but offers additional benefits in improving lipid profile, fasting glucose, and microalbuminuria.
Moxonidine may be preferred over amlodipine in obese hypertensives for metabolic gains; extends RCT evidence for central agents in this subgroup.
Background: High blood pressure is frequently associated with metabolic alterations such as insulin resistance, impaired glucose tolerance, dyslipidaemia and obesity. Moxonidine, a selective imidazoline receptor agonist, reduces activity of sympathetic nervous system and lowers blood pressure, and has been shown to have benecial effects on lipid and carbohydrate metabolism. The present study has been conducted to evaluate antihypertensive efcacy of moxonidine and compare it with amlodipine in mild to moderate hypertension in obese patients. Methods: This was an open-label randomized study. Patients were divided into two groups of 50 patients each, rst group was given amlodipine 5 mg daily and the second group was given moxonidine 0.2 mg once daily. At the end of 8 weeks, the therapeutic effects of both regimes on blood pressure in obese patients with stage 1 and stage 2 hypertension were compared and also with lipid prole, fasting sugars and microalbuminuria. Results: The study involved 100 participants with a mean age of 51.12±6.25 years and 48.88±5.15 years in moxonidine group and amlodipine group, respectively. Systolic and diastolic blood pressure reduction was signicant in both groups at 8-weeks (p<0.001). The reduction in FBS (p=0.008), total cholesterol (p=0.04), serum triglycerides (p<0.001) and increase in HDL (p=0.02) were all signicant in moxonidine group, but LDL reduction was not signicant. In amlodipine group, change in FBS, total cholesterol, serum triglycerides, HDL and LDL levels were all insignicant. There was also signicant reduction in microalbuminuria in moxonidine group. Conclusion: Moxonidine and amlodipine are equally effective antihypertensives and safe in obese hypertensives. Moxondine has additional favourable effects on lipid prole (serum cholesterol, TGs and LDL), fasting blood glucose and microalbuminuria.
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Kansal et al. (2021) conducted an RCT in mild to moderate hypertension in obese patients (n=100). Moxonidine vs. Amlodipine 5 mg daily was evaluated on blood pressure reduction (p=<0.001). Moxonidine and amlodipine equally reduced blood pressure in obese hypertensives at 8 weeks (p<0.001), while moxonidine additionally improved fasting sugars, lipids, and microalbuminuria.
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