AIM: OF THE STUDY: To evaluate the efficacy and tolerability of rilmenidine (Tenaxum) in the dose of 1-2 mg in patients with mild to moderate hypertension.
GROUP OF PATIENTS AND METHODS: 243 patients (53% men, 47% women, mean age 52 +/- 11 years with mild to moderate essential hypertension were included into the study. Several cardiovascular risk factors for CAD were reported in the investigated group of patients: dyslipidaemia in 54%, obesity in 29%, diabetes mellitus in 14% and smoking in 17% of subjects. 87% of patients were subjects with newly diagnosed untreated or shortly (< 3 months) treated hypertension. In remaining hypertensives the antihypertensive therapy was withdrawn two weeks before the beginning of rilmenidine treatment. The following parameters were studied: BMI, sitting and upright casual blood pressure, heart rate and basal laboratory tests. If necesary, additional therapy with indapamide or perindopril was allowed.

RESULTS: Rilmenidine treatment resulted in normalisation of blood pressure (BP) or significant (decrease of SBP/DBP = 20/10 mm Hg) blood pressure decrease in 69%, 22% of subjects, respectively. At the end of 6-month period significant BP decrease was noted: 134 +/- 6/83 +/- 5 mm Hg vs. 161 +/- 12/99 +/- 6 mm Hg (p < 0.001). Marked BP decrease was observed already during first visit after active treatment for 3 weeks. Six months of rilmenidine treatment led to significant heart rate decrease (71/min. +/- 8 vs. 74/min. +/- 9, p < 0.01). No significant laboratory (plasma Na, K, creatinine, urea, glycemia, triglycerides, haematocrit) changes were reported after rilmenidine treatment with the only exception of mild, but significant plasma cholesterol decrease. Rilmenidine had very good acceptability and mild side effects were noted in small percentage of patients.

CONCLUSION: Rilmenidine is a centraly acting drug of IInd generation (imidazoline I1 receptors agonist) with potent antihypertensive and mild negative chronotropic effect. Rilmenidine has very good clinical tolerability without negative influence on metabolic parameters.

Keywords: Adrenergic alpha-Agonists /adverse effects/; Antihypertensive Agents /adverse effects/; Blood Pressure /drug effects/; Female; Humans; Hypertension /complications/; Male; Middle Aged; Oxazoles /adverse effects/; Rilmenidine; Risk Factors