A 6-month clinical study with active therapeutic intervention was carried out to evaluate the efficacy of moxonidine for the correction of arterial hypertension in 30 patients with metabolic syndrome. Along with the metabolic neutrality for the lipid and purine metabolism, the drug demonstrated a distinct antihypertensive effect, which against the background of pronounced sympatholytic action after 3 months of therapy tends to disappear, which can be prevented by dosage correction. It was shown that the efficacy of moxonidine in reducing insulin resistance in patients with metabolic syndrome directly depends on the severity of hypersympathicotonia manifesting in heart rate over 80 bpm at rest.