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724 MOXONIDINE EFFICACY ON BLOOD PRESSURE REDUCTION REVEALED IN A METABOLIC SYDNROME POPULATION: MAIN RESULTS OF THE MERSY STUDY

Background: Hypertension and the metabolic syndrome (MS) often coexist and are important contributors to overall cardiovascular risk. Activation of the sympathetic nervous system (SNS) is implicated in both conditions. Design and Methods: We initiated an international multi-center, open-label observational study to assess the effects of moxonidine (0.2–0.4 mg/d)as monotherapy or in combination on blood pressure and aspects of the MS. A total of 5603 patients from 13 countries were enrolled and treated for 6 months. The rate of responders to treatment defined as attainmentof BP <140/90mmHg (<130/80mmHg for diabetic patients) was the primary efficacy endpoint. Results: There was an equal gender distribution andmean age was 56.8±11.5 years. Mean body mass index was 32.5±5.0 kg/m2. 2.3% of subjects reported a SADR, 12 of which were serious. Moxonidine treatment was associated with an average BP reduction of 24.5/12.6 mmHg (from 158.3/94.1 to 133.7/81.6mmHg) at six months, resulting in a responder rate of 42%. Responder rates were higher among younger patients (44.3% vs. 33.4%), non-postmenopausal women (52.8% vs. 38.5%) and patients receiving monotherapy (55.7% vs. 37.8%). Clinically relevant improvements were observed in several aspects of the MS including reductions in body weight (–2.1±5.4 kg), fasting plasma glucose (from 6.8 to 6.2mmol/L), and triglycerides (2.4 to 2.0mmol/L). Conclusions: Moxonidine therapy is associated with substantially improved rates of blood pressure control and accompanied by clinically relevant changes in aspects of the MS. These results identify the SNS as a preferred therapeutic target in hypertensive patients with MS.