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


Journal

Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882

Informations de publication

Date de publication:
15 May 2024
Historique:
medline: 15 5 2024
pubmed: 15 5 2024
entrez: 15 5 2024
Statut: aheadofprint

Résumé

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.

Identifiants

pubmed: 38747424
doi: 10.1097/HJH.0000000000003769
pii: 00004872-990000000-00471
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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Auteurs

Markus P Schlaich (MP)

Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia.

Konstantinos Tsioufis (K)

First Department of Cardiology, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece.

Stefano Taddei (S)

Department of Clinical and Experimental Medicine, University of Pisa, Pisa.

Claudio Ferri (C)

University of L'Aquila, MeSVA Department, UOC Internal Medicine & Nephrology, Hypertension and Cardiovascular Prevention Unit - San Salvatore Hospital, L'Aquila, Italy.

Mark Cooper (M)

Monash University, Melbourne.

Andrew Sindone (A)

Heart Failure Unit, Concord Hospital and University of Sydney, Sydney, Australia.

Claudio Borghi (C)

Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.

John Parissis (J)

University Clinic of Emergency Medicine, Attikon University Hospital, Athens.

Maria Marketou (M)

University of Crete, School of Medicine, Heraklion, Crete, Greece.

Ana Maria Vintila (AM)

Internal Medicine and Cardiology Department, Carol Davila University of Medicine and Pharmacy Bucharest, Romania; Coltea Clinical Hospital, Bucharest.

Anca Farcas (A)

Department of Internal Medicine, 'Iuliu Hatieganu' University of Medicine and Pharmacy, Romania.

Marcio G Kiuchi (MG)

Dobney Hypertension Centre, Medical School - Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia.

Shukrath Chandrappa (S)

Manager, Medical, Viatris Inc, Bangalore, India.

Classifications MeSH