The role of moxonidine in the treatment of vasovagal syncope and primary hypertension

Abstract

Background In pathophysiology of vasovagal syncope (VVS) participates the autonomic nervous system. VVS frequently coexists with hypertension. Pharmacological proceeding in this group of patients is peculiarly difficult. As well the autonomic nervous system participates in pathophysiology of hypertension. The effect of treatment on components of autonomic nervous system can be measured by heart rate variability (HRV). The aim of the study was the analysis of the effect of treatment with moxonidine in hypertensive patients with vasovagal syncope and analysis of HRV parameters.
Material and methods 40 patients (32% male, mean age 60 ± 10.8 years) with history of recurrent syncope and mild or moderate hypertension were involved in research. In control group were 20 patients (30% male, mean age 59 ± 11.4 years) with mild or moderate hypertension without syncope. In all patients were performed: the initial history, HRV analysis, ambulatory blood pressure monitoring and head-up tilt testing (HUTT) before and during the treatment of moxonidine.
Results In the patients with VVS and hypertension during the therapy of moxonidine significant reduce of number of syncope (p < 0.001), of prodromal symptoms (p < 0.01) and substantial reduce of positive outcome of HUTT (p < 0.001) were documented. Moreover in this group of patients no statistic differences in LF parameters after tilting in comparison to control group and before therapy were noted.
Conclusions Moxonidine beyond the hypotensive effect reduces frequency of syncope and elevated activity of sympathetic component in patients with vasovagal syncope and hypertension.