Orlistat in hypertensive overweight/obese patients: results of a randomized clinical trial

J Hypertens. 2003 Nov;21(11):2159-65. doi: 10.1097/00004872-200311000-00026.

Abstract

Objective: To assess the effect of orlistat plus diet compared with diet alone in promoting weight loss and blood pressure reduction in hypertensive, overweight/obese patients.

Design: A pragmatic randomized, controlled trial.

Setting: Hypertension clinic of a university hospital.

Patients: Hypertensive patients aged 18-75 years with a body mass index greater than 25 kg/m(2).

Interventions: Orlistat 360 mg/day combined with a hypocaloric diet (treatment group), or a calorie-restricted diet alone (control group).

Main outcome measures: Primary outcomes were reductions in weight and blood pressure. Secondary outcomes were decreases in lipid and glucose concentrations. A subgroup analysis of the main outcomes among diabetic and non-diabetic patients was also performed.

Results: A total of 204 patients were included in the intention-to-treat analysis. After 12 weeks the orlistat group lost, on average, 3.7 kg and the control group lost 2.0 kg in weight (P < 0.001). Systolic (SBP) and diastolic (DBP) blood pressures decreased by 15.3 and 11.4 mmHg, respectively, in the group given orlistat plus a hypocaloric diet and by 11.6 and 5.2 mmHg, respectively, in the control group given the calorie-restricted diet alone (P = 0.25 and P = 0.0004, respectively). Fasting glucose (0.82 and 0.17 mmol/l, P = 0.01) and total cholesterol (0.85 and 0.56 mmol/l, P = 0.05) were reduced to a greater extent with orlistat than with diet alone. The mean reduction in triglycerides with orlistat plus the hypocaloric diet was 0.75 mmol/l and that in the control group was 0.30 mmol/l (P = 0.28); the increases in high-density lipoprotein cholesterol were 0.05 and 0.00 mmol/l, respectively, in the two groups (P = 0.17). Treatment improved blood pressure and glucose control in the individuals with diabetes, but not in those without diabetes.

Conclusion: In both groups there was a reduction in weight, blood pressure and metabolic parameters. The orlistat group performed better in reducing weight, DBP, glucose and cholesterol. Results show that even a small reduction in weight helps to control blood pressure and glucose. The cost-benefit of the use of orlistat should be evaluated for hypertensive obese patients.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Obesity Agents / adverse effects
  • Anti-Obesity Agents / therapeutic use*
  • Blood Glucose / analysis
  • Blood Pressure
  • Body Mass Index
  • Caloric Restriction
  • Cholesterol / blood
  • Diabetes Complications
  • Diabetes Mellitus / diet therapy
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / pathology
  • Diastole
  • Fasting / blood
  • Female
  • Humans
  • Hypertension / complications*
  • Hypertension / physiopathology
  • Lactones / adverse effects
  • Lactones / therapeutic use*
  • Lipids / blood
  • Male
  • Middle Aged
  • Obesity / complications*
  • Obesity / diet therapy
  • Obesity / drug therapy*
  • Obesity / pathology
  • Orlistat
  • Systole
  • Weight Loss

Substances

  • Anti-Obesity Agents
  • Blood Glucose
  • Lactones
  • Lipids
  • Orlistat
  • Cholesterol