Weight-reducing drugs may be beneficial in hypertensive patients

January 01, 0001

Weight-reducing drugs may be beneficial in hypertensive patients

Clinical Question:How effective are weight-reducing drugs in hypertensive patients?

Bottom line: Although trials of orlistat and sibutramine in patients with elevated blood pressure demonstrated statistically significant decreases in weight, orlistat reduced blood pressure and sibutramine increased blood pressure.

Caveat: No long term mortality and morbidity RCT evidence is available for these drugs. Trials of rimonabant in this patient population could not be included.

Context: Orlistat, sibutramine and rimonabant are the main anti-obesity drugs in current use. Orlistat and sibutramine have been approved for long term treatment of obesity throughout much of the world. Rimonabant was approved for use in the European Union in 2006, and has also been approved in some South American and Asian countries. Rimonabant does not have US Food and Drug Administration (FDA) approval since preclinical and clinical data raised concerns about associations between rimonabant and increased frequency of psychiatric adverse events, including suicidality, an ill-defined constellation of neurological signs and symptoms, and seizures. In January 2009, the European Commission issued a decision to withdraw market authorisation for rimonabant in all countries of the European Union.

Cochrane Systematic Review: Siebenhofer A et al. Long term effects of weight-reducing drugs in hypertensive patients. Cochrane Reviews 2009, Issue 3. Article No. CD007654. DOI: 10.1002/14651858.CD007654.pub2. This review contains 8 studies involving 2726 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 207, November 2009.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: K. Circulatory, T. Endocrine/Metabolic/Nutritional. Keywords: weigth reduction, drug therapy, hypertension
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 30 March 2010

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.