Orlistat and cardiovascular risk profile in hypertensive patients with metabolic syndrome: the ARCOS study.
Weight loss improves metabolic abnormalities and reduces cardiovascular risk in obese hypertensive patients. To evaluate the impact of a sustained weight loss on coronary risk, 181 hypertensive patients with metabolic syndrome underwent to orlistat therapy, 120 mg, t.i.d., plus diet for 36 weeks. During therapy, Framingham risk scores (FRS) were calculated for determination of coronary heart disease risk in ten years. Body mass index decreased from 35.0 +/- 4.2 to 32.6 +/- 4.5 kg/m(2) (p< 0.0001) and waist circumference from 108.1 +/- 10.1 to 100.5 +/- 11.1 cm (p< 0.0001), at the end of the study period (week 36). Systolic and diastolic blood pressure showed reductions after the two first weeks, which were maintained up to the end of the study. A clear shift to the left in FRS distribution curve occurred at the end of the study, compared to baseline, indicating a reduction in coronary risk. Over all patients at risk, 49.2% moved to a lower risk category. A weight loss > 5% occurred in 64.6% of all patients, associated with improvement in glucose metabolism. Among those with abnormal glucose metabolism, 38 out 53 patients (71.7%) improved their glucose tolerance (p< 0.0005). In conclusion, long-term orlistat therapy helps to reduce and maintain a lower body weight, decreasing risk of coronary disease and improving glucose metabolism, thus protecting against type 2 diabetes.
Zanella
Maria Teresa
MT
Divisions of Endocrinology, Federal University of São Paulo. tereza.zanella@hrim.com.br
Uehara
Marcelo Hiroshi
MH
Ribeiro
Artur Beltrame
AB
Bertolami
Marcelo
M
Falsetti
Ana Claudia
AC
Yunes
Mirela A
MA
D000328:Adult; D000368:Aged; D019440:Anti-Obesity Agents / Q000494:pharmacology / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications; D007783:Lactones / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D009765:Obesity / Q000178:diet therapy / Q000188:drug therapy*; D000077403:Orlistat; D049629:Waist-Hip Ratio; D015431:Weight Loss / Q000187:drug effects*
D019440:Anti-Obesity Agents; D007783:Lactones; D000077403:Orlistat