Body Weight Changes with β-Blocker Use: Results from GEMINI - 09/08/11
, David S.H. Bell, MB b, Vivian Fonseca, MD c, Richard E. Katholi, MD d, Janet B. McGill, MD e, Robert A. Phillips, MD, PhD f, Philip Raskin, MD g, Jackson T. Wright, MD, PhD h, Sripal Bangalore, MD a, Fred K. Holdbrook, PhD i, Mary Ann Lukas, MD i, Karen M. Anderson, PhD i, George L. Bakris, MD jGEMINI Investigators
Requests for reprints should be addressed to Franz H. Messerli, MD, St. Luke’s-Roosevelt Hospital Center, Cardiology 3B-30, 1000 10th Ave., New York, NY 10019.Abstract |
Purpose |
Patients with type 2 diabetes are commonly overweight, which can contribute to poor cardiovascular outcomes. β-blockers may promote weight gain, or hamper weight loss, and are a concern in high-risk patients. The current analysis of the Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial evaluates the effects of carvedilol and metoprolol tartrate on weight gain in patients with type 2 diabetes and hypertension.
Methods |
This prespecified secondary analysis of the GEMINI study (n=1106) evaluated change in body weight after 5 months.
Results |
Mean (±SE) baseline weights were 97.5 (±20.1) kg for carvedilol and 96.6 (±20.1) kg for metoprolol tartrate. Treatment difference (c vs m) in mean (±SE) weight change from baseline was −1.02 (±0.21) kg (95% confidence interval [CI], −1.43 to −0.60; P <.001). Patients taking metoprolol had a significant mean (±SE) weight gain of 1.19 (±0.16) kg (P <.001); patients taking carvedilol did not (0.17 [±0.19] kg; P =.36). Metoprolol tartrate-treated patients with body mass index (BMI) >30 kg/m2 had a statistically significant greater weight gain than comparable carvedilol-treated patients. Treatment differences (c vs m) in the obese (BMI >30 kg/m2) and morbidly obese groups (BMI >40 kg/m2) were −0.90 kg (95% CI, −1.5 to −0.3; P =.002) and −1.84 kg (95% CI, −2.9 to −0.8; P =.001), respectively. Pairwise correlation analyses revealed no significant associations between weight change and change in HbA1c, HOMA-IR, or blood pressure.
Conclusions |
Metoprolol tartrate was associated with increased weight gain compared to carvedilol; weight gain was most pronounced in subjects with hypertension and diabetes who were not taking insulin therapy.
Le texte complet de cet article est disponible en PDF.Keywords : β-blockers, Body Mass Index (BMI), Carvedilol, Diabetes, Hypertension, Metoprolol, Weight
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Vol 120 - N° 7
P. 610-615 - juillet 2007 Retour au numéro
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