Effects of sibutramine plus verapamil sustained release/trandolapril combination on blood pressure and metabolic variables in obese hypertensive patients

• DOI: 10.1517/14656566.9.10.1629
• Publication Date: 2008-06-21T07:23:26Z
• Authors: E Nakou; TD Filippatos; EN Liberopoulos; AD Tselepis; DN Kiortsis; DP Mikhailidis; MS Elisaf
• Keywords: Male; obesity; verapamil; coronary-artery-disease; Indoles; dense ldl; prebetal high-density lipoprotein; Blood Pressure; low-density lipoprotein subfractions; Appetite Depressants/administration & dosage/*therapeutic use; 0302 clinical medicine; Heart Rate; plasma visfatin levels; sibutramine; randomized trial; Nicotinamide Phosphoribosyltransferase; Antihypertensive Agents/administration & dosage/*therapeutic use; 2. Zero hunger; Heart Rate/drug effects; waist circumference; Lipids; 3. Good health; Drug Combinations; C-Reactive Protein; Hypertension/complications/*drug therapy; Hypertension; Drug Therapy, Combination; Female; double-blind; Cyclobutanes/administration & dosage/*therapeutic use; weight-loss; Adult; hypertension; Obesity/complications/*drug therapy; Nicotinamide Phosphoribosyltransferase/drug effects; Blood Pressure/drug effects; 12. Responsible consumption; C-Reactive Protein/analysis; 03 medical and health sciences; Indoles/administration & dosage/*therapeutic use; visfatin; Appetite Depressants; Humans; Body Weights and Measures; Obesity; trandolapril; Antihypertensive Agents; low-density lipoprotein cholesterol; Lipids/blood; Verapamil/administration & dosage/*therapeutic use; heart-disease; Diet; phospholipase a(2); Delayed-Action Preparations; Cyclobutanes

The management of obese hypertensive subjects may require the administration of anti-obesity and antihypertensive drugs. Sibutramine use has raised concerns regarding a potential increase in subjects' blood pressure and heart rate. The primary end-points of this study were an evaluation of the effect of sibutramine together with a verapamil sustained release/trandolapril combination tablet versus verapamil sustained release/trandolapril alone on the blood pressure and heart rate in obese hypertensive patients.Patients received a low-fat low-calorie diet and were randomly allocated to open-label verapamil sustained release/trandolapril 180/2 mg (n = 26) or sibutramine 10 mg together with verapamil sustained release/trandolapril 180/2 mg (n = 28) daily for 6 months.Significant reductions in the subjects' systolic blood pressure and diastolic blood pressure were observed in both groups (p < 0.01 versus baseline). At 6 months a greater fall in blood pressure was observed in the sibutramine/verapamil sustained release/trandolapril group compared with the verapamil sustained release/trandolapril group (systolic blood pressure 21.9 +/- 8.1 versus 15.9 +/- 12.3 mmHg and diastolic blood pressure 15.7 +/- 8.1 versus 9.1 +/- 9.9 mmHg) but this was only significant (p = 0.03) for diastolic blood pressure. The subjects' heart rate did not change significantly in any group. No significant sibutramine-associated attenuation of blood pressure reduction was observed during the study. The sibutramine/verapamil sustained release/trandolapril treatment resulted in significantly greater improvement in the subjects' anthropometric variables, homeostasis model assessment and lipid profiles compared with verapamil sustained release/trandolapril administration. The subjects' small dense low-density lipoprotein cholesterol, high-sensitivity C-reactive protein and visfatin plasma levels were only measured in the sibutramine/verapamil sustained release/trandolapril group (all decreased by p < 0.05 versus baseline).The sibutramine/verapamil sustained release/trandolapril combination in obese hypertensive patients significantly reduced their blood pressure and improved their anthropometric and metabolic variables without affecting the heart rate.