Metoprolol weight gain
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Metoprolol and Weight Gain: Analyzing the Evidence
Introduction to Metoprolol and Weight Gain
Metoprolol, a beta-blocker commonly prescribed for hypertension and other cardiovascular conditions, has been associated with weight gain in patients. This article synthesizes findings from multiple studies to provide a comprehensive understanding of the relationship between metoprolol and weight gain, particularly in overweight and hypertensive patients.
Weight Gain in Patients with Type 2 Diabetes and Hypertension
GEMINI Trial Insights
The Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial provides significant insights into the effects of metoprolol on body weight. In this study, patients with type 2 diabetes and hypertension who were treated with metoprolol tartrate experienced a notable weight gain. Specifically, the mean weight gain for metoprolol-treated patients was 1.19 kg over five months, compared to a minimal weight change in patients treated with carvedilol1. This weight gain was more pronounced in patients with a body mass index (BMI) greater than 30 kg/m², indicating that metoprolol may have a more substantial impact on weight in obese individuals1.
Comparison with Weight Reduction Strategies
Randomized Placebo-Controlled Trials
Two randomized placebo-controlled trials compared the effects of metoprolol with weight reduction strategies in overweight patients with mild hypertension. In these studies, patients who underwent weight reduction lost an average of 7.4 kg over 21 weeks, which was significantly more than the weight change observed in the metoprolol group2 3. Additionally, the weight reduction group experienced greater improvements in systolic and diastolic blood pressure compared to the metoprolol group2 3.
Impact on Lipid Profiles
The trials also highlighted differences in lipid profiles between the two groups. Patients in the weight reduction group saw decreases in total cholesterol and the ratio of total to high-density lipoprotein (HDL) cholesterol. In contrast, those treated with metoprolol experienced a decrease in HDL cholesterol and an increase in the ratio of total to HDL cholesterol, indicating potential adverse effects on lipid metabolism2 3.
Conclusion
The evidence suggests that metoprolol is associated with weight gain, particularly in patients with type 2 diabetes and hypertension. This weight gain is more pronounced in obese individuals. In contrast, weight reduction strategies not only lead to significant weight loss but also improve blood pressure and lipid profiles without the adverse effects associated with metoprolol. These findings underscore the importance of considering alternative treatments and lifestyle modifications for managing hypertension in overweight patients.
Sources and full results
Most relevant research papers on this topic
Body weight changes with beta-blocker use: results from GEMINI.
Metoprolol tartrate is associated with increased weight gain compared to carvedilol, particularly in patients with hypertension and diabetes not taking insulin therapy.
Observational StudyCOMPARISON OF WEIGHT REDUCTION WITH METOPROLOL IN TREATMENT OF HYPERTENSION IN YOUNG OVERWEIGHT PATIENTS
Weight reduction significantly reduces blood pressure in overweight patients aged under 55 without the adverse effects on plasma lipids associated with antihypertensive drug therapy.
RCT
Highly CitedTreatment of high blood pressure in overweight patients.
Weight reduction significantly lowers blood pressure and left ventricular mass in overweight patients without the adverse effects on plasma lipids associated with antihypertensive drug therapy.
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T3 increases right ventricular pressure and pulmonary artery pressure, but not left ventricular pressure, and metoprolol reduces this increase.
Non-RCT
Animal StudyA RANDOMIZED CONTROLLED TRIAL OF WEIGHT REDUCTION AND METOPROLOL IN THE TREATMENT OF HYPERTENSION IN YOUNG OVERWEIGHT PATIENTS
Weight reduction and metoprolol effectively reduce blood pressure in young, overweight patients with hypertension.
RCTSensitivity to insulin during treatment with atenolol and metoprolol: a randomised, double blind study of effects on carbohydrate and lipoprotein metabolism in hypertensive patients.
Long-term use of metoprolol and atenolol causes metabolic abnormalities, potentially contributing to the increased incidence of diabetes in patients with hypertension treated pharmacologically.
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Metoprolol exposure during pregnancy can cause intrauterine growth restriction, but discontinuing treatment can lead to a normal fetal growth outcome.
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Metoprolol suppresses the development of ethanol-induced cardiac hypertrophy in rats, suggesting a beta-adrenoceptor mediated link in this process.
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Metoprolol and pizotifen show no statistically significant difference in efficacy for prophylactic migraine treatment, but metoprolol is generally well-tolerated and has fewer side effects.
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Metoprolol effectively reduces blood pressure and plasma renin activity in essential hypertension patients, with varying effects depending on individual factors.
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