Efficacy and Tolerability of Long-Term Rilmenidine Treatment in Hypertensive Diabetic Patients

Introduction Rilmenidine is a centrally acting antihypertensive which differs from the other representatives of this class by its very high specificity for the imidazoline I 1 receptors and its good tolerability. Recent studies have shown rilmenidine improves glucose tolerance and reduces micro-albuminuria in patients with diabetes mellitus. Methodology The evidence of these potentially favorable characteristics encouraged a secondary retrospective analysis of a subgroup of 2738 diabetic patients included in a previous long-term open study of rilmenidine alone, or in combination with other classes of antihypertensives. Results The antihypertensive efficacy of rilmenidine demonstrated previously in controlled studies was confirmed during the 12-month follow-up. In addition, favorable effects of drug treatment on fasting blood glucose and plasma triglyceride levels were consistent with an improvement in glucose and lipid metabolism during treatment. The profile of adverse events was similar to that observed in the nondiabetic population, the occurrence of postural hypotension being observed in <1% of patients and not necessitating any withdrawals from the study. Conclusion Diabetic hypertensive patients frequently require the use of multiple medications and consideration of the metabolic interactions between treatments. The results of this retrospective analysis support the use of rilmenidine in patients with hypertension and diabetes mellitus and should encourage the conduct of controlled trials of cardiovascular and renal protection and outcome with this compound.