Effect of Metformin on Weight Gain During Antihypertensive Treatment With a β-Blocker in Chinese Patients

• Published in: American journal of hypertension Vol. 22; no. 8; pp. 884 - 890
• Main Authors: Zhang, Jian-liang, Zheng, Xing, Zou, Da-jin, Qiu, Jian-li, Zhao, Xian-xian, Qin, Yong-wen
• Format: Journal Article
• Language: English
• Published: Basingstoke Oxford University Press 01.08.2009; Nature Publishing Group
• Subjects: Adrenergic beta-Antagonists - adverse effects; Adrenergic beta-Antagonists - therapeutic use; Aged; Antihypertensive agents; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Arterial hypertension. Arterial hypotension; Atenolol - adverse effects; Atenolol - therapeutic use; Biological and medical sciences; Blood and lymphatic vessels; Blood Glucose - metabolism; Body Mass Index; Calcium Channel Blockers - adverse effects; Cardiology. Vascular system; Cardiovascular system; 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; Medical sciences; Metabolic Syndrome - complications; Metformin - therapeutic use; Middle Aged; Nitrendipine - adverse effects; Nitrendipine - therapeutic use; Obesity - complications; Obesity - drug therapy; Overweight - complications; Overweight - drug therapy; Pharmacology. Drug treatments; Prospective Studies; Weight Gain - drug effects; Human; Hypertension; Hypoglycemic agent; Biguanides; Treatment; Antihypertensive agent; Chinese; Cardiovascular disease; Metformin; Weight gain
• ISSN: 0895-7061; 1879-1905; 1941-7225
• DOI: 10.1038/ajh.2009.93

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) ≥25 kg/m2, 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. American Journal of Hypertension 2009; 22:884–890 © 2009 American Journal of Hypertension, Ltd.