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Kristy Denmead


Start date

Jun 2015

Submission date

Kristy Denmead

Thesis

Sympathoinhibition as a preferred second line treatment of obesity related hypertension

Summary

Obesity and hypertension frequently coexist, with at least 75% of the incidence of hypertension directly related to obesity. Despite an emphasis on lifestyle modification, pharmacologic therapeutic intervention is often required in the overweight and obese population. Sympathetic nervous system overactivity has been strongly linked with hypertension and in the obese population it is associated with hyperinsulinaemia, inappropriate leptin secretion and renin-angiotensin-aldosterone system overactivity, as well as other metabolic consequences.

We aim to establish a combination of antihypertensive drugs for use specifically by patients with obesity-related hypertension. We will be comparing the efficacy of combination therapy of an ACE inhibitor (perindopril) and a calcium channel blocker (amlodipine) which is a commonly used therapeutic regime, with the combination of perindopril and a sympatholytic agent (moxonidine). We hypothesise that the latter combination is more efficacious than the current drug recommendation for lowering blood pressure in this cohort. We will also be comparing relevant metabolic markers between these two treatment groups and we anticipate more favourable outcomes (such as improvements to body weight, glucose metabolism and lipid profiles) with monoxidine therapy.

Why my research is important

There is currently no specific recommendation for combination therapy in obese patients, despite this population's unique risk profile and clear evidence of high sympathetic tone that is left untargeted by commonly used regimens. Our study will determine whether sympatholytic antihypertensive therapy using moxonidine should become the preferred second line treatment for these patients.