The aim of our research was to evaluate the effectiveness of the imidazoline receptor agonist - moxonidine («Physiotens») in the treatment for high blood pressure at patients with diabetes mellitus type 2 associated with the chronic obstructive pulmonary disease (COPD).
Materials and methods: our study group included 28 patients with diabetes mellitus type 2 (average age - 53,7±3,1 years old, duration of diabetes mellitus - 9,8±1,1 years) associated with COPD of I-II stages (GOLD, 2003). Mild COPD was diagnosed at 21 patients, moderate - at 7 patients. All patients received Physiotens as a monotherapy in dose 0,2 mg/day with titration till 0,6 mg/day. The therapy duration was 24 weeks. All patients received the earlier prescribed broncholytic therapy. The examination of the test persons included the following aspects: daily monitoring of blood pressure; evaluation of microcirculation by bulbar biomicroscopy method including estimation of perivascular space, vessels and intravascular blood flow and determination of conjunctival indices; examination of endothelium-dependent vasodilation; measuring insulin resistance according to HOMA IR. The function of external respiration was studied using lung-tester «Spiro S-100».
Results: after the treatment, the average daily systolic blood pressure reduced by 13,3% (p<0,01), and diastolic by 10,1% (p<0,05). Daily blood pressure profiles showed a positive dynamics; variability, value and velocity of the morning rise in blood pressure reduced (p<0,01). All studied parameters of the microcircular blood flow improved: we observed a diminution of perivascular edema, higher velocity of microcircular blood flow and disappearing of «sludge syndrome». Perivascular conjunctival index reduced from 2,12±0,08 till 1,85±0,09 (p<0,05); vascular - from 14,13±1,11 till 10,12±0,91 (p<0,01); intravascular - from 6,94±0,44 till 5,39±0,31 (p<0,05). Evaluating the endothelium-dependent vasodilation, we could see a reliable growth of brachial artery diameter (p<0,05). The HOMA IR index reduced reliably (p<0,05) after taking Physiotens. We have not observed any statistically significant changes in external respiration during the conducted study.
Conclusion: Physiotens (moxonidine) can be recommended as a basic therapeutic medication to correct blood pressure at patients with diabetes mellitus type 2 associated with COPD.
The work was submitted to the International Scientific Conference «Medical, social and economic problems of population health preservation», Kemer (Turkey), May 20-27, 2009. Came to the editorial office on 30.04.2009.