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Efficacy and Tolerability of Long-Term Rilmenidine Treatment in Hypertensive Diabetic Patients

A Retrospective Analysis of a General Practice Study

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Abstract

Introduction

Rilmenidine is a centrally acting antihypertensive which differs from the other representatives of this class by its very high specificity for the imidazoline I1 receptors and its good tolerability. Recent studies have shown rilmenidine improves glucose tolerance and reduces micro-albuminuria in patients with diabetes mellitus.

Methodology

The evidence of these potentially favorable characteristics encouraged a secondary retrospective analysis of a subgroup of 2738 diabetic patients included in a previous long-term open study of rilmenidine alone, or in combination with other classes of antihypertensives.

Results

The antihypertensive efficacy of rilmenidine demonstrated previously in controlled studies was confirmed during the 12-month follow-up. In addition, favorable effects of drug treatment on fasting blood glucose and plasma triglyceride levels were consistent with an improvement in glucose and lipid metabolism during treatment. The profile of adverse events was similar to that observed in the nondiabetic population, the occurrence of postural hypotension being observed in <1% of patients and not necessitating any withdrawals from the study.

Conclusion

Diabetic hypertensive patients frequently require the use of multiple medications and consideration of the metabolic interactions between treatments. The results of this retrospective analysis support the use of rilmenidine in patients with hypertension and diabetes mellitus and should encourage the conduct of controlled trials of cardiovascular and renal protection and outcome with this compound.

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References

  1. Arauz-Pacheco C, Parrot MA, Raskin P. The treatment of hypertension in adult patients with diabetes. Diabetes Care 2002; 125: 13447

    Google Scholar 

  2. Gress TW, Nieto FJ, Shahar E, et al. Hypertension and hypertensive therapy as the risk factor for type 2 diabetes. Atherosclerosis Risk in Communities Study. N Engl J Med 2000; 342: 905–12

    Article  PubMed  CAS  Google Scholar 

  3. Haffner SM, Lehto S, Ronnemaa T, et al. Mortality from coronary heart disease in subjects with type 2 diabetes and in non-diabetic subjects with and without prior myocardial infarction. N Engl J Med 1998; 339: 229–34

    Article  PubMed  CAS  Google Scholar 

  4. Hansson L, Zanchetti A, Carruthers G, et al. for the Hypertension Optimal Treatment (HOT) Study Group. Effects of intensive blood-pressure lowering and low-dose aspirin in patients with hypertension: principal results of the HOT randomised trial. Lancet 1998; 351: 1755–62

    Article  PubMed  CAS  Google Scholar 

  5. United Kingdom Prospective Diabetes Study (UKPDS) Group. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. BMJ 1998; 317: 703–13

    Article  Google Scholar 

  6. The Sixth Report of the Joint National Committee on prevention detection, evaluation and treatment of high blood pressure. Arch Int Med 1997; 157: (21) 2413-46

    Google Scholar 

  7. World Health Organization International Society of Hypertension Guidelines for the Management of Hypertension. J Hypertens 1999; 17:(2) 151–83

    Google Scholar 

  8. Chowdhury TA, Kumar S, Rocella EJ, et al. Prevalence of hypertension in patients with type 2 diabetes: a review of the recent evidence. J Hum Hypertens 1999; 13: 803–11

    Article  PubMed  CAS  Google Scholar 

  9. Bakris GL. A practical approach to achieving recommended blood pressure goals in diabetic patients. Arch Intern Med 2001; 161: 10–24

    Article  Google Scholar 

  10. Parving HH, Lehnert H, Bröchner-Mortensen J, et al. The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes. N Engl J Med 2001; 345(12): 870–8

    Article  PubMed  CAS  Google Scholar 

  11. Brenner BM, Cooper ME, De Zeeuw D, et al. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med 2001; 345(12): 861–9

    Article  PubMed  CAS  Google Scholar 

  12. Lewis EJ, Hunsicker LG, Clarke WR, et al. Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med 2001; 345(12): 851–60

    Article  PubMed  CAS  Google Scholar 

  13. Louis WJ, O’Callaghan PR, Conway EL, et al. Centrally acting drugs. In: Swales J, editor. Textbook of hypertension. London: Blackwell Scientific, 1994: 1033–45

    Google Scholar 

  14. Bricca G, Dontenwil M, Feldman J, et al. Rilmenidine selectivity for imidazoline receptors in human brain. Eur J Pharmacol 1989; 163: 373–7

    Article  PubMed  CAS  Google Scholar 

  15. De Luca N, Izzo R, Fontana D, et al. Haemodynamic and metabolic effect of rilmenidine in hypertensive patients with metabolic syndrome X A double-blind parallel study versus amlodipine. J Hypertens 2000; 18: 1515–22

    Article  PubMed  Google Scholar 

  16. Bauduceau B, Mayaudon H, Dupuy O. Efficacy of rilmenidine selective I1 imidazoline receptor agent, in hypertensive diabetics. J Cardiovasc Risk 2000; 7: 57–61

    PubMed  CAS  Google Scholar 

  17. Trimarco B. Contribution of an I1 selective agent in the management of hypertensive patients with metabolic syndrome X [abstract]. Am J Hypertens 1999; 12: 221A

    Article  Google Scholar 

  18. Luccioni R. Efficacy and acceptability of rilmenidine in 18 235 hypertensive patients over 1 year. Presse Med 1995; 124: 1827–64

    Google Scholar 

  19. Izzo JL, Levy D, Black HR. Clinical advisory statement: importance of systolic blood pressure in older Americans. Hypertension 2000; 5: 1021–4

    Article  Google Scholar 

  20. Fiorentin C, Guillet C, Guazzi M. Etude multicentrique italiennne en double aveugle comparant la rilménidine lmg et l’hydrochlorothiazide 25mg chez 444 patients. Arch Mal CØur Vaiss 1989; 82: 39–46

    Google Scholar 

  21. Scemama M, Fevrier B, Beucler I, et al. Lipid profile and hypertensive patients: comparison of rilmenidine and captopril. J Cardiovasc Pharmacol 1995; 26 Suppl 2: S34–9

    Article  PubMed  CAS  Google Scholar 

  22. Pelemans W, Verhaeghe J, Creytens G, et al. Efficacy and safety of rilmenidine in elderly patients: comparison with hydrochlorothiazide. The Belgium Multicenter Study Group. Am J Cardiol 1994; 74: 51–57A

    Article  Google Scholar 

  23. Reaven G. Role of insulin resistance and the sympathoadrenal system. Diabetes 1988; 37: 1595–160

    Article  PubMed  CAS  Google Scholar 

  24. American Diabetes Association. Treatment of hypertension in adults with diabetes. Diabetes Care 2002; 25: 199–201

    Article  Google Scholar 

  25. Kaplan NM. The deadly quartet: upper body obesity, glucose intolerance, hypertriglyceridemia and hypertension. Arch Intern Med 1989; 149: 1514–20

    Article  PubMed  CAS  Google Scholar 

  26. Penicaud L, Berthault MF, Morin J, et al. Rilmenidine normalizes fructose-induced insulin resistance and hypertension in rats. J Hypertens 1998; 16 Suppl. 3: S45–9

    CAS  Google Scholar 

  27. Julius S, Majahalme S, Palatini P. Antihypertensive treatment of patients with diabetes and hypertension. Am J Hypertens 2001; 14: 310–316S

    Article  Google Scholar 

  28. Soergel M, Schaefer F. Effect of hypertension on the progression of chronic renal failure in children. Am J Hypertens 2002; 15: 53–56S

    Article  Google Scholar 

  29. The GISEN Group (Gruppo Italiano di Studi Epidemiologici in Nefrologia). Randomised placebo-controlled trial of effect of ramipril on decline in glomerular filtration rate and risk of terminal renal failure in proteinuric, nondiabetic nephropathy. Lancet 1997; 349: 1857–63

    Article  Google Scholar 

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Acknowledgements

This report describes a secondary analysis of a previously published clinical trial. The authors did not receive any financial support for the conduct of the clinical study. Both authors have received research grants and consultancies from several pharmaceutical companies including Bayer, GSK, MSD, Pfizer, Servier and Takeda.

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Authors and Affiliations

  1. Division of Cardiovascular and Medical Sciences, The University of Glasgow, The Western Infirmary, Glasgow, G11 6NT, Scotland, UK

    Peter A. Meredith & John L. Reid

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  1. Peter A. Meredith
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  2. John L. Reid
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Correspondence to Peter A. Meredith.

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Meredith, P.A., Reid, J.L. Efficacy and Tolerability of Long-Term Rilmenidine Treatment in Hypertensive Diabetic Patients. Am J Cardiovasc Drugs 4, 195–200 (2004). https://doi.org/10.2165/00129784-200404030-00006

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