gms | German Medical Science

Aim: To investigate interaction of different combinations of two antihypertensive drugs on sibutramine(Sib)-induced weight reduction and influence on blood pressure (bp) in non-adequately controlled obese hypertensive patients.

Methods: Randomized, placebo-controlled, multicenter study in 169 hypertensive patients with a BMI= 27-<45kg/m2 who were randomly assigned to receive one of three combinations of two antihypertensive agents (D:5mg felodipine/5mg ramipril, B:95mg metoprolol/12.5mg HCT, T:180mg verapamilSR/2mg trandolapril). After two weeks of antihypertensive treatment patients with grade 1 hypertension (140-159/90-99mmHg) were assigned to receive treatment with Sib 10/15 mg or placebo (Plac) for 16 weeks. Patients were controlled for body weight, bp (office, 24h-ABPM) and quality of life (QoL).

Results: Weight reduction in Plac patients was 1.1% for all antihypertensive combinations. Sib patients exhibited a significantly reduced body weight. Weight reduction was greatest for T and D (-6.0 and -6,7%, respectively) and somewhat less for the betablocker/HCT combination (-3.3%). Office bp was reduced in both groups (Sib: -5.6/-0.2, Plac: -5.2/-2.8mmHg) while 24h-ABPM levels were unchanged (Sib: -0.1/2.4, Plac: -1.2/-0.7mmHg). Heart rate significantly increased by +5.3 and decreased by 2.8 beats/min in Sib and Plac patients, respectively with no relevant differences between the antihypertensive treatment groups. QoL improvement was significantly greater in Sib than in Plac patients; the smallest increase was seen in B.

Conclusions: Sib significantly reduced body weight in obese hypertensive patients. The betablocker/HCT based strategy produced the smallest reduction. In addition, Sib has no negative impact on bp.