title: Response to six classes of antihypertensive medications by body mass index in a randomized controlled trial.
abstract: Blood pressure increases with increasing body mass index (BMI) and BMI is linearly related to blood pressure in population studies. Obesity has been said to cause resistance to antihypertensive medications. We compared short-term and 1-year blood pressure response by BMI category and weight change with hydrochlorothiazide, atenolol, diltiazem-SR, captopril, clonidine, prazosin, or placebo in 1292 male veterans. Drug doses were titrated to achieve goal diastolic blood pressure <90 mm Hg over 4-8 weeks. Patients who achieved goal blood pressure were maintained for 1 year. BMI did not predict change in systolic, diastolic or pulse pressures during titration for any drug. At 1 year obese patients (BMI >30) were 2.5 times more likely to have diastolic blood pressure controlled by atenolol than normal weight (BMI <27) patients (p=0.01). Only prazosin patients gained weight: 1.7 lb (end-titration, p<0.0001; 1-year, p=0.02). Obesity does not appear to cause resistance to antihypertensive medications.
authors.affiliation: Cooperative Studies Program of the Department of Veterans Affairs, Office of Research and Development and the Department of Medicine, University of Miami, Miami, FL 33136, USA. bmaterson@miami.med.edu
authors.forename: Barry J
authors.initials: BJ
authors.lastname: Materson
authors.forename: David W
authors.initials: DW
authors.lastname: Williams
authors.forename: Domenic J
authors.initials: DJ
authors.lastname: Reda
authors.forename: William C
authors.initials: WC
authors.lastname: Cushman
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000378:metabolism / Q000503:physiopathology
chemical_list: D000959:Antihypertensive Agents