Sibutramine and blood pressure: a therapeutic dilemma

Bray, George A.

doi:10.1038/sj.jhh.1001297

Cited by 13 publications

(6 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We did not see increases in blood pressure or pulse as have been reported in some trials using sibutramine (14). It is possible that any effect of weight loss to reduce blood pressure was offset by an effect of sibutramine to increase blood pressure.…”

Section: Adverse Effectsmentioning

confidence: 63%

One-Year Outcome of a Combination of Weight Loss Therapies for Subjects With Type 2 Diabetes

et al. 2003

View full text Add to dashboard Cite

OBJECTIVE -The purpose of this study was to evaluate the effects of a combination weight loss program using intermittent low-calorie diets, energy-controlled meal replacement products, and sibutramine on weight loss, diabetes control, and cardiovascular risk factors in overweight or obese subjects with type 2 diabetes.RESEARCH DESIGN AND METHODS -Overweight or obese individuals with type 2 diabetes treated with diet or oral medication were randomly assigned to either a standard therapy or combination therapy group. Both groups received a standardized program to facilitate weight loss. The combination therapy group also received 10 -15 mg sibutramine daily, low-calorie diets using meal replacement products for 1 week every 2 months, and between low-calorie diet weeks, once daily use of meal replacement product and snack bars to replace one usual meal and snack. Primary outcome measures were changes in body weight, glycemic control, plasma lipids, blood pressure, pulse, and body composition at 1 year.RESULTS -At 1 year, combination therapy, compared with standard therapy, resulted in significantly more weight loss (Ϫ7.3 Ϯ 1.3 kg vs. Ϫ0.8 Ϯ 0.9 kg, P Ͻ 0.001) and reduction in HbA 1c (Ϫ0.6 Ϯ 0.3 vs. 0.0 Ϯ 0.2%, P ϭ 0.05). Combination therapy resulted in reduced requirement for diabetes medications and decreased fat mass and lean body mass. A 5-kg decrease in weight at 1 year was associated with a decrease of 0.4% in HbA 1c (P ϭ 0.006). Changes in fasting glucose, lipids, pulse, and blood pressure did not differ between groups.CONCLUSIONS -This combination weight loss program resulted in greater weight loss and improved diabetes control compared with a standard weight loss program in overweight or obese subjects with type 2 diabetes.

show abstract

Section: Adverse Effectsmentioning

confidence: 63%

One-Year Outcome of a Combination of Weight Loss Therapies for Subjects With Type 2 Diabetes

et al. 2003

View full text Add to dashboard Cite

show abstract

“…However, the relation between sibutramine and BP was considered as a therapeutic dilemma. [57] Indeed, because of its mode of action, sibutramine treatment could somewhat dampen the classically observed reduction in arterial BP resulting from weight loss as shown in several meta-analyses. [50,53,[58][59][60] In a meta-analysis of 21 double-blind, randomised controlled trials of sibutramine, modest increases in systolic and diastolic BP were observed in patients treated with sibitramine as compared to placebo.…”

Section: Sibutramine and Sympathetic Nervous System Blood Pressurementioning

confidence: 99%

Cardiovascular Risk-Benefit Profile of Sibutramine

Scheen

2010

American Journal Cardiovascular Drugs

View full text Add to dashboard Cite

SUMMARYSibutramine is a combined norepinephrine and serotonin reuptake inhibitor used as an antiobesity agent to reduce appetite and promote weight loss in combination with diet and exercise. At a daily dose of 10-20 mg, it was initially considered to have a good safety profile as it does not induce primary pulmonary hypertension or adverse effects on cardiac valves, in contrast to what was previously reported with some other anti-obesity agents. However, it exerts

show abstract

“…28 However, it is now well known that the effects of sibutramine on blood pressure during long-term treatment differ markedly from its short-term application and depend on preexisting blood pressure levels. Short-term sibutramine application significantly increases resting blood pressure in healthy normal-weight subjects, whereas a number of studies have demonstrated that longterm therapy in obese patients results in only minor changes in SBP and DBP compared with placebo.…”

Section: Scholze Et Almentioning

confidence: 99%

Optimal Treatment of Obesity-Related Hypertension

et al. 2007

View full text Add to dashboard Cite

Background-Current guidelines for the treatment of hypertension do not provide specific recommendations for obese hypertensive patients. To identify an optimal treatment regimen for obese hypertensive patients, we studied the interactions between a drug-based weight loss approach by sibutramine and different antihypertensive drug regimens. Methods and Results-This was a prospective, 16-week double-blind placebo-controlled randomized multicenter study in 171 obese hypertensive patients. After a 2-week run-in period, patients receiving 1 of the 3 antihypertensive combination therapies (felodipine 5 mg/ramipril 5 mg [nϭ57], verapamil 180 mg/trandolapril 2 mg [nϭ55], or metoprolol succinate 95 mg/hydrochlorothiazide 12.5 mg [metoprolol/hydrochlorothiazide; nϭ59]) were assigned randomly to sibutramine (15 mg) or placebo. Sibutramine treatment resulted in a significantly greater decrease in body weight, body mass index, and waist circumference and a significant increase in diastolic blood pressure during 24-hour blood pressure monitoring compared with placebo treatment. Sibutramine-induced weight loss and reduction of visceral obesity were markedly attenuated in the metoprolol/hydrochlorothiazide group compared with the other groups. Consistently, improvement in glucose tolerance and hypertriglyceridemia by sibutramine was abrogated in the cohort treated with metoprolol/ hydrochlorothiazide compared with the other groups. Conclusions-The present study demonstrates for the first time that an antihypertensive combination therapy regimen with angiotensin-converting enzyme inhibitors and calcium channel blockers is more advantageous than a ␤-blocker/diuretic-based regimen in supporting the weight-reducing actions and concomitant metabolic changes induced by sibutramine in obese hypertensive patients. These data may help to develop future comprehensive treatment strategies and guidelines for this high-risk patient population.

show abstract

Sibutramine and blood pressure: a therapeutic dilemma

Cited by 13 publications

References 23 publications

One-Year Outcome of a Combination of Weight Loss Therapies for Subjects With Type 2 Diabetes

One-Year Outcome of a Combination of Weight Loss Therapies for Subjects With Type 2 Diabetes

Cardiovascular Risk-Benefit Profile of Sibutramine

Optimal Treatment of Obesity-Related Hypertension

Contact Info

Product

Resources

About