Effect of sibutramine on weight loss and blood pressure: a meta-analysis of controlled trials.
OBJECTIVE
Sibutramine causes weight loss by suppressing the appetite and by promoting energy expenditure, but it can also increase blood pressure through a norepinephrine effect. The aim of this study was to provide a comprehensive meta-analysis of randomized, controlled trials on the effects of sibutramine on blood pressure and weight loss.


METHODS
Twenty-one placebo-controlled, double-blind, randomized trials of sibutramine were identified using MEDLINE, EMBASE, and a manual search. The effect sizes of sibutramine on weight and systolic (SBP) and diastolic (DBP) blood pressure changes were estimated. Subgroup analyses were undertaken to explore the relationship between effect sizes and the study characteristics.


RESULTS
The effect size of sibutramine on weight change was -1.00 (-1.17 to -0.84), whereas the effect sizes on SBP and DBP changes were 0.16 (0.08 to 0.24) and 0.26 (0.18 to 0.33), respectively. By subgroup analysis, the effect sizes on weight loss were significantly larger when the dosage was > or = 15 mg. The effect sizes on increased SBP were significantly larger when the initial body weight was > or = 92 kg and the age was < 44 years; similarly, the effect sizes on increased DBP were significantly larger when the initial weight was > or = 92 kg.


CONCLUSIONS
Sibutramine showed a large effect on weight loss. Because blood pressure was found to be increased slightly, but significantly, sibutramine should be used cautiously in patients with borderline or high blood pressure. Additional studies on its effect on blood pressure are needed.
Kim
Su Hyun
SH
Department of Epidemiology and Health Promotion, Graduate School of Health Science and Management, Yonsei University, Seoul, Republic of Korea.
Lee
Young Mee
YM
Jee
Sun Ha
SH
Nam
Chung Mo
CM
D000328:Adult; D001067:Appetite Depressants / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects*; D003503:Cyclobutanes / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004734:Energy Metabolism / Q000187:drug effects; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic
D001067:Appetite Depressants; D003503:Cyclobutanes; C058254:sibutramine