Effect of metformin on weight gain during antihypertensive treatment with a beta-blocker in Chinese patients.
BACKGROUND
Overweight and obesity are associated with cardiovascular disease (CVD). This study was designed to investigate whether combined use of nitrendipine and atenolol has any effect on body weight (BW) and whether metformin can prevent antihypertensive medication-induced weight gain and has any effect on blood glucose (BG).


METHODS
Included in the present study were 94 hypertensive patients with a body mass index (BMI) > or =25 kg/m(2), of whom 45 patients were treated with nitrendipine plus atenolol (N/A group), and the remaining 49 patients were treated with nitrendipine, atenolol, and metformin (N/A/M group). The mean follow-up duration was 14 months. BW and glucose tolerance were measured.


RESULTS
In N/A group, BW and fasting BG significantly increased from 73.5 +/- 9.6 kg to 74.2 +/- 9.7 kg (P < 0.05) and from 94.2 +/- 10.5 mg/dl to 97.9 +/- 11.3 mg/dl (P < 0.01), respectively, whereas postprandial BG did not change significantly. In N/A/M group, BW slightly decreased from 72.7 +/- 10.1 kg to 72.3 +/- 10.2 kg (P = 0.30), and fasting BG did not change significantly (93.5 +/- 10.4 mg/dl vs. 92.7 +/- 10.2 mg/dl, P = 0.59), whereas 2-h postprandial BG significantly decreased from 133.7 +/- 30.5 mg/dl to 124.0 +/- 29.6 mg/dl (P < 0.05). Furthermore, a significant difference was observed in difference value of BW before and after treatment between the two groups (0.7 (95% confidence interval, 0.1-1.3) kg in N/A group vs. -0.4 (95% confidence interval, -1.3 to 0.4) kg in N/A/M group, P < 0.05).


CONCLUSIONS
Combination therapy of nitrendipine and atenolol may significantly increase BW and fasting BG in overweight or obese patients with hypertension. Metformin may prevent BW gain and improve BG levels in hypertensive patients who received combination therapy of nitrendipine and atenolol.
Zhang
Jian-liang
JL
Department of Cardiology, Changhai Hospital, Second Military Medical University, Shanghai, China.
Zheng
Xing
X
Zou
Da-jin
DJ
Qiu
Jian-li
JL
Zhao
Xian-xian
XX
Qin
Yong-wen
YW
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects* / Q000627:therapeutic use; D000368:Aged; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001262:Atenolol / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002121:Calcium Channel Blockers / Q000009:adverse effects; D002681:China; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005951:Glucose Tolerance Test; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007333:Insulin Resistance / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008687:Metformin / Q000627:therapeutic use*; D008875:Middle Aged; D009568:Nitrendipine / Q000009:adverse effects / Q000627:therapeutic use; D009765:Obesity / Q000150:complications / Q000188:drug therapy; D050177:Overweight / Q000150:complications / Q000188:drug therapy; D011446:Prospective Studies; D015430:Weight Gain / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D001786:Blood Glucose; D002121:Calcium Channel Blockers; D007004:Hypoglycemic Agents; D008055:Lipids; D001262:Atenolol; D008687:Metformin; D009568:Nitrendipine