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Sibutramine and blood pressure: a therapeutic dilemma

Journal of Human Hypertension volume 16, pages 1–3 (2002)Cite this article

The prevalence of obesity has increased dramatically over the past two decades.1 This epidemic has already shown its impact through the increasing prevalence of type 2 diabetes in adolescents. We can also anticipate a major epidemic of diabetes in adults and more hypertension and heart disease unless the tide is turned. Preventive strategies are the first line of defence, but when these fail, treatment is the primary option. At present only two drugs are approved for long-term use in the treatment of obesity, and both have troublesome side effects. The two papers2,3 in this issue of the Journal of Human Hypertension focus on the effect of the anti-obesity drug sibutramine on the blood pressure of hypertensive patients treated for their hypertension.

A positive relationship of blood pressure and overweight has been demonstrated in most studies.4,5 Moreover, weight loss induced by non-pharmacologic means reduces blood pressure6,7,8 and this reduction is maintained while the blood pressure remains down.9 However, a note of caution was recently raised by the Swedish Obese Subjects study where weight loss of 20% from baseline was induced by gastric surgical operations. Although body weight and blood pressure initially fell as expected, by the fourth year of post-operative follow-up blood pressure had returned to control levels, even though body weight remained reduced from baseline.10

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  1. Pennington Biomedical Research Center, Baton Rouge, 70808, LA, USA

    G A Bray

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Bray, G. Sibutramine and blood pressure: a therapeutic dilemma. J Hum Hypertens 16, 1–3 (2002). https://doi.org/10.1038/sj.jhh.1001297

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