Rilmenidine therapy potential in pharmaceutical correction of endothelial dysfunction among women with arterial hypertension, Type 2 diabetes mellitus, and visceral obesity
Aim. To assess the effectiveness of a selective I<sub>1</sub>- imidazoline receptor agonist, rilmenidine, in women with Stage I arterial hypertension (AH), Type 2 diabetes mellitus (DM-2), and visceral obesity (VO), taking into account antihypertensive effects and dynamics of endothelial dysfunction (ED) biochemical markers. Material and methods. In total, 27 women with DM-2, Stage I AH, and VO, not receiving any regular antihypertensive treatment before, were examined. Mean participants' age was 52,0±5,5 years, mean duration of DM-2, AH, and VO - 3,23±1,0, 5,93±2,28, and 13,53±3,75 years, respectively. Anthropometry, 24-hour blood pressure monitoring (BPM), measurement of endotheline-1 (ET-1), stable NO metabolites (NO<sub>n</sub>), fasting and postprandial glucose, as well as glycated hemoglobin (%) levels were performed. Results. Rilmenidine therapy (1 mg/d) was associated with target BP level achievement in 77,8% of the patients, decrease in mean 24-hour, daytime and nighttime systolic BP (SBP) by 10,6%, 12,1% and 7%, respectively (р<0,001), and regression of "load" parameters. Circadian SBP index significantly increased (by 3,29 mm Hg; р<0,001), the percentage of patients with normal circadian rhythm («dippers») increased from 49,3% to 74,2%. Heart rate was significantly reduced, from 85,24±4,78 to 72,32±4,24 bpm (р<0,05). Rilmenidine and atorvastatin therapy was associated with reduction in the levels of total cholesterol (by 27%; p<0,05), low-density lipoprotein cholesterol (by 36%; p<0,01), and triglycerides (by 24%; p<0,05). BP decrease and lipid profile improvement were accompanied by decreased ET-1 activity (by 50%; р<0,05) and increased NO<sub>n</sub> concentration (by 9,7%; р<0,05). No negative effects on carbohydrate metabolism were registered during the follow-up period. Conclusion. The results obtained could be used as an additional argument supporting rilmenidine therapy for AH management in women with DM-2 and VO.