Background: Even though patients with class 3 obesity (body mass index ≥ 40 kg/m(2)) are prone to arterial hypertension and respond less to antihypertensive drugs, they are not considered in hypertension treatment guidelines and data from prospective clinical trials are lacking.
Methods: In a post hoc analysis of a clinical trial, we compared patients with class 3 obesity with patients with class 1/2 obesity.
Results and conclusions: Blood pressure control in class 3 obesity was less likely to be achieved with hydrochlorothiazide monotherapy. While addition of amlodipine, irbesartan, or aliskiren to hydrochlorothiazide improved the blood pressure response, amlodipine was less effective and induced peripheral edema in 19% of patients with class 3 obesity.
Keywords: aliskiren; hypertension; irbesartan; morbid obesity; obesity; placebo; renin.