Treatment of hypertension in metabolic syndrome
A.Yu. Runikhin¹, A.K. Ragozin¹, N.K. Runikhina<sup>2

1</sup> N.I. Pirogov Russian National Research Medical University, Moscow, Russia
² Russian Gerontology Scientific and Clinical Center, Moscow, Russia

The paper discusses current diagnostic criteria of metabolic syndrome, its clinical manifestations, and pathogenesis of hypertension (HP) in metabolic syndrome. Indications for initiating antihypertensive therapy and target blood pressure (BP) levels in metabolic syndrome with HP are summarized. Target BP depending on the presence or absence of diabetes in metabolic syndrome is assessed. Various classes of antihypertensive drugs used to control BP in metabolic syndrome are described. The advantages of angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, calcium antagonists, and selective agonist of imidazoline receptor (moxonidine) as preferred antihypertensive medications in these patients are discussed. Different combined regimes of antihypertensive therapy in metabolic syndrome are compared. According to the Guidelines of European Society of Cardiology and Russian Society of Cardiology, renin-angiotensin system blocking drug with calcium antagonist or diuretic is the most rational two-component antihypertensive combination in metabolic syndrome. Possible clinical situations in which moxonidine with ACE inhibitor or angiotensin II receptor blocker can be considered as an optimal antihypertensive regimen are reviewed. Efficient antihypertensive combination therapy in metabolic syndrome may include three, four, five, or six drugs.

Key words: metabolic syndrome, hypertension, moxonidine, antihypertensive drugs, combination therapy of hypertension.

For citation: Runikhin A.Yu., Ragozin A.K., Runikhina N.K. Treatment of hypertension in metabolic syndrome // RMJ. Cardiology. 2016. № 9. P. –584.