J Med Assoc Thai 2003; 86 (10):903

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Efficacy and Safety of Rilmenidine, a Selective Imidazoline 11 Receptor Binding Ligand, in Mild-to-Moderate Thai Hypertensive Patients Rilmenidine Thai Study Group
Buranakitjapoen P Mail, Kittipawong P , Silaraks S , Sukonthasam A , Tiyapant A

PEERAPONG KITTIPA WONG, MD**,
CHUMPOL PIAMSOMBOON, MD****,
SONGKW AN SILARAKS, MD******,
ASSADA TIYAPANT, MD********
Background
: Rilmenidine is an antihypertensive agent that selectively binds to imidazoline
1
1
receptor located in the brain stem and kidney. It acts both centrally by reducing sympathetic over-
activity and in the kidney by decreasing water and sodium overload. This dual action leads to the
immediate and delayed control of blood pressure caused by this drug.
Objective
: The aim of this study was to assess the efficacy and safety of rilmenidine as
monotherapy in mild-to-moderate essential hypertensive patients.
Method
: An 8-week, open-labeled, multicenter study was conducted in Thai patients with
mild-to-moderate essential hypertension. Rilmenidine I mg/day was given for 8 weeks. The dose could
be titrated up to 2 mg/day according to the patient's blood pressure response at week 4. The primary
efficacy parameters were the mean reductions in systolic and diastolic blood pressure. The proportions
of patients whose blood pressure normalized or responded were evaluated as secondary efficacy para-
meters. Safety parameters were assessed by the changes in heart rate and reported side effects during
the treatment period.
Results:
103 subjects (44.7% men) with a mean age of 53เธ‘ 9.7 years completed the 8-week
follow-up. At baseline, 46.6 per cent and 53.4 per cent of the patients were classified with mild and
moderate hypertension, respectively. The mean blood pressure was 154/93 mmHg. After the 8-week
treatment, there was a significant decrease in blood pressure to 140/86 mmHg (p
<
0.001), with mean
pressure reduction of 14/7.5 mmHg. The normalization rate was 44 per cent and the response rate was
68 per cent. No significant changes were found for mean heart rate and any laboratory parameters tested.
Only 17 patients reported mild and transient side effects such as drowsiness and dryness of the mouth
and throat, which required no treatment.
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