Effect of metformin on weight gain during antihypertensive treatment with a beta-blocker in Chinese patients

Am J Hypertens. 2009 Aug;22(8):884-90. doi: 10.1038/ajh.2009.93. Epub 2009 Jul 2.

Abstract

Background: Overweight and obesity are associated with cardiovascular disease (CVD). This study was designed to investigate whether combined use of nitrendipine and atenolol has any effect on body weight (BW) and whether metformin can prevent antihypertensive medication-induced weight gain and has any effect on blood glucose (BG).

Methods: Included in the present study were 94 hypertensive patients with a body mass index (BMI) > or =25 kg/m(2), of whom 45 patients were treated with nitrendipine plus atenolol (N/A group), and the remaining 49 patients were treated with nitrendipine, atenolol, and metformin (N/A/M group). The mean follow-up duration was 14 months. BW and glucose tolerance were measured.

Results: In N/A group, BW and fasting BG significantly increased from 73.5 +/- 9.6 kg to 74.2 +/- 9.7 kg (P < 0.05) and from 94.2 +/- 10.5 mg/dl to 97.9 +/- 11.3 mg/dl (P < 0.01), respectively, whereas postprandial BG did not change significantly. In N/A/M group, BW slightly decreased from 72.7 +/- 10.1 kg to 72.3 +/- 10.2 kg (P = 0.30), and fasting BG did not change significantly (93.5 +/- 10.4 mg/dl vs. 92.7 +/- 10.2 mg/dl, P = 0.59), whereas 2-h postprandial BG significantly decreased from 133.7 +/- 30.5 mg/dl to 124.0 +/- 29.6 mg/dl (P < 0.05). Furthermore, a significant difference was observed in difference value of BW before and after treatment between the two groups (0.7 (95% confidence interval, 0.1-1.3) kg in N/A group vs. -0.4 (95% confidence interval, -1.3 to 0.4) kg in N/A/M group, P < 0.05).

Conclusions: Combination therapy of nitrendipine and atenolol may significantly increase BW and fasting BG in overweight or obese patients with hypertension. Metformin may prevent BW gain and improve BG levels in hypertensive patients who received combination therapy of nitrendipine and atenolol.

Publication types

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

MeSH terms

  • Adrenergic beta-Antagonists / adverse effects*
  • Adrenergic beta-Antagonists / therapeutic use
  • Aged
  • Antihypertensive Agents / adverse effects*
  • Antihypertensive Agents / therapeutic use
  • Atenolol / adverse effects*
  • Atenolol / therapeutic use
  • Blood Glucose / metabolism
  • Body Mass Index
  • Calcium Channel Blockers / adverse effects
  • China
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Glucose Tolerance Test
  • Humans
  • Hypertension / complications*
  • Hypertension / drug therapy
  • Hypoglycemic Agents / therapeutic use*
  • Insulin Resistance / physiology
  • Lipids / blood
  • Male
  • Metabolic Syndrome / complications
  • Metformin / therapeutic use*
  • Middle Aged
  • Nitrendipine / adverse effects
  • Nitrendipine / therapeutic use
  • Obesity / complications
  • Obesity / drug therapy
  • Overweight / complications
  • Overweight / drug therapy
  • Prospective Studies
  • Weight Gain / drug effects*

Substances

  • Adrenergic beta-Antagonists
  • Antihypertensive Agents
  • Blood Glucose
  • Calcium Channel Blockers
  • Hypoglycemic Agents
  • Lipids
  • Atenolol
  • Metformin
  • Nitrendipine