Metabolic sequelae of β-blocker therapy: weighing in on the obesity epidemic?
- 8 February 2011
- journal article
- research article
- Published by Springer Science and Business Media LLC in International Journal of Obesity
- Vol. 35 (11), 1395-1403
- https://doi.org/10.1038/ijo.2010.284
Abstract
Sympathetic activation is an important metabolic adaptation limiting weight gain. Propensity of weight gain associated with β-blocker therapy in the obese modern population is unknown. To determine whether chronic β-blocker therapy reduces energy expenditure (EE) and increases body weight. We undertook (i) a mechanistic study comparing EE, diet-induced thermogenesis and habitual activity between healthy volunteers (n=11) with uncomplicated hypertension treated with a β-blocker and anthropometrically matched controls (n=19) and (ii) three cross-sectional studies comparing body weight, body mass index (BMI) and waist circumference between β-blocker treated and untreated patients from ambulatory patients attending (a) diabetes outpatient clinic (n=214), (b) hypertension outpatient (n=84) and (c) participants in a multi-centre type 2 diabetes trial (ADVANCE) (n=11140). Among weight-matched β-blocker users, diet-induced thermogenesis, fat oxidation rate and weekly habitual activity were lower by 50% (PP=0.04) and 30% (PP=0.0002) higher among those attending the diabetes clinic, 17.2±3.2 kg (P=0.004) higher among those attending the hypertension clinic and 5.2±0.7 kg (P=0.0003) higher at baseline among participants in the ADVANCE trial compared with patients not treated with β-blockers. BMI displayed a similar difference. EE is reduced and body weight increased in chronic β-blocker users. We hypothesise that chronic β-blockade causes obesity by blunting EE.Keywords
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