Targeting the sympathetic nervous system with the selective imidazoline receptor agonist moxonidine for the management of hypertension: an international position statement.

IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Journal of Hypertension Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI:10.1097/HJH.0000000000003769
Markus P Schlaich, Konstantinos Tsioufis, Stefano Taddei, Claudio Ferri, Mark Cooper, Andrew Sindone, Claudio Borghi, John Parissis, Maria Marketou, Ana Maria Vintila, Anca Farcas, Marcio G Kiuchi, Shukrath Chandrappa
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引用次数: 0

Abstract

Hypertension is often linked with metabolic risk factors that share common pathophysiological pathways. Despite wide-spread availability of multiple drug classes, optimal blood pressure (BP) control remains challenging. Increased central sympathetic outflow is frequently neglected as a critical regulator of both circulatory and metabolic pathways and often remains unopposed therapeutically. Selective imidazoline receptor agonists (SIRAs) effectively reduce BP with a favorable side effect profile compared with older centrally acting antihypertensive drugs. Hard outcome data in hypertension, such as prevention of stroke, heart and kidney diseases, are not available with SIRAs. However, in direct comparisons, SIRAs were as effective as angiotensin-converting enzyme inhibitors, β-blockers, calcium channel blockers, and diuretics in lowering BP. Other beneficial effects on metabolic parameters in hypertensive patients with concomitant overweight and obesity have been documented with SIRAs. Here we review the existing evidence on the safety and efficacy of moxonidine, a widely available SIRA, compared with common antihypertensive agents and provide a consensus position statement based on inputs from 12 experts from Europe and Australia on SIRAs in hypertension management.

用选择性咪唑啉受体激动剂莫索尼定靶向交感神经系统治疗高血压:国际立场声明。
高血压通常与代谢风险因素有关,这些因素具有共同的病理生理途径。尽管有多种药物可供选择,但血压(BP)的最佳控制仍然具有挑战性。中枢交感神经外流增加作为循环和代谢途径的一个关键调节因素,经常被忽视,在治疗上也往往得不到抑制。选择性咪唑啉受体激动剂(SIRAs)能有效降低血压,与老式的中枢作用型降压药相比副作用小。选择性咪唑啉受体激动剂没有关于高血压的硬性结果数据,如预防中风、心脏和肾脏疾病。不过,在直接比较中,SIRAs 与血管紧张素转换酶抑制剂、β-受体阻滞剂、钙通道阻滞剂和利尿剂一样有效降低血压。对于同时伴有超重和肥胖的高血压患者,SIRAs 对代谢指标的其他有益作用也已得到证实。在此,我们回顾了有关莫索尼定安全性和有效性的现有证据,莫索尼定是一种广泛使用的 SIRA,与常见的降压药物进行了比较,并根据来自欧洲和澳大利亚的 12 位专家就高血压治疗中的 SIRA 提出的意见,提供了一份共识立场声明。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Hypertension
Journal of Hypertension 医学-外周血管病
CiteScore
7.90
自引率
6.10%
发文量
1389
审稿时长
3 months
期刊介绍: The Journal of Hypertension publishes papers reporting original clinical and experimental research which are of a high standard and which contribute to the advancement of knowledge in the field of hypertension. The Journal publishes full papers, reviews or editorials (normally by invitation), and correspondence.
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