New Modern Centrally Acting Antihypertensives in the Treatment of Essential Hypertension

Overview

It was recently found that the rise of blood pressure leads to the excitation of a vasomotor centre in the brain stemand that the accompanying decrease in brain cortex excitability results in the reduced sensitivity to various adversestimuli. Centrally acting antihypertensives, moxonidine and rilmenidine, do not impair circulatory reflexes andtherefore do not deprive the patient of a chance to resist the pressure; thus the compliance of the patient might beincreased. Both drugs activate I1-imidazoline receptors on the neurons of the rostral ventrolateral medulla oblongata.The reduction of neuronal firing rate results in the decrease of sympathetic activity and arterial pressure. Beside otheradvantages, centrally acting antihypertensives might be more promising than peripherally acting drugs due to their possiblemore favourable psychopharmacological profile; this component of their action might be underestimated at present.

Key words:
essential hypertension, patient compliance, moxonidine, rilmenidine, imidazoline receptors.