title: Body weight changes with beta-blocker use: results from GEMINI.
abstract: OBJECTIVE
  Patients with type 2 diabetes are commonly overweight, which can contribute to poor cardiovascular outcomes. beta-blockers may promote weight gain, or hamper weight loss, and are a concern in high-risk patients. The current analysis of the Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial evaluates the effects of carvedilol and metoprolol tartrate on weight gain in patients with type 2 diabetes and hypertension.
  
  
  METHODS
  This prespecified secondary analysis of the GEMINI study (n=1106) evaluated change in body weight after 5 months.
  
  
  RESULTS
  Mean (+/-SE) baseline weights were 97.5 (+/-20.1) kg for carvedilol and 96.6 (+/-20.1) kg for metoprolol tartrate. Treatment difference (c vs m) in mean (+/-SE) weight change from baseline was -1.02 (+/-0.21) kg (95% confidence interval [CI], -1.43 to -0.60; P <.001). Patients taking metoprolol had a significant mean (+/-SE) weight gain of 1.19 (+/-0.16) kg (P <.001); patients taking carvedilol did not (0.17 [+/-0.19] kg; P =.36). Metoprolol tartrate-treated patients with body mass index (BMI) >30 kg/m2 had a statistically significant greater weight gain than comparable carvedilol-treated patients. Treatment differences (c vs m) in the obese (BMI >30 kg/m2) and morbidly obese groups (BMI >40 kg/m2) were -0.90 kg (95% CI, -1.5 to -0.3; P =.002) and -1.84 kg (95% CI, -2.9 to -0.8; P =.001), respectively. Pairwise correlation analyses revealed no significant associations between weight change and change in HbA1c, HOMA-IR, or blood pressure.
  
  
  CONCLUSIONS
  Metoprolol tartrate was associated with increased weight gain compared to carvedilol; weight gain was most pronounced in subjects with hypertension and diabetes who were not taking insulin therapy.
authors.affiliation: St. Luke's-Roosevelt Hospital Center, New York City, NY 10019, USA. FMesserli@aol.com
authors.forename: Franz H
authors.initials: FH
authors.lastname: Messerli
authors.forename: David S H
authors.initials: DS
authors.lastname: Bell
authors.forename: Vivian
authors.initials: V
authors.lastname: Fonseca
authors.forename: Richard E
authors.initials: RE
authors.lastname: Katholi
authors.forename: Janet B
authors.initials: JB
authors.lastname: McGill
authors.forename: Robert A
authors.initials: RA
authors.lastname: Phillips
authors.forename: Philip
authors.initials: P
authors.lastname: Raskin
authors.forename: Jackson T
authors.initials: JT
authors.lastname: Wright
authors.forename: Sripal
authors.initials: S
authors.lastname: Bangalore
authors.forename: Fred K
authors.initials: FK
authors.lastname: Holdbrook
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Lukas
authors.forename: Karen M
authors.initials: KM
authors.lastname: Anderson
authors.forename: George L
authors.initials: GL
authors.lastname: Bakris
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects; D002227:Carbazoles / Q000494:pharmacology / Q000627:therapeutic use; D000077261:Carvedilol; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D008297:Male; D008790:Metoprolol / Q000494:pharmacology / Q000627:therapeutic use; D008875:Middle Aged; D011412:Propanolamines / Q000494:pharmacology / Q000627:therapeutic use; D011446:Prospective Studies
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol; D008790:Metoprolol