BACKGROUND: Sympathetic activation is an important metabolic adaptation limiting weight gain. Propensity of weight gain associated with beta-blocker therapy in the obese modern population is unknown. OBJECTIVE: To determine whether chronic beta-blocker therapy reduces energy expenditure (EE) and increases body weight. METHODS: 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 beta-blocker and anthropometrically matched controls (n=19) and (ii) three cross-sectional studies comparing body weight, body mass index (BMI) and waist circumference between beta-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). RESULTS: Among weight-matched beta-blocker users, diet-induced thermogenesis, fat oxidation rate and weekly habitual activity were lower by 50% (P<0.01), 32% (P=0.04) and 30% (P<0.01), respectively, compared with controls. In beta-blocker treated patients, the adjusted mean body weight was 9.2 +/- 1.2 kg (P=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 beta-blockers. BMI displayed a similar difference. CONCLUSIONS: EE is reduced and body weight increased in chronic beta-blocker users. We hypothesise that chronic beta-blockade causes obesity by blunting EE.
AD - Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia. AN - 21304487 BT - International Journal of Obesity (Lond) DP - NLM ET - 2011/02/10 LA - eng M1 - 11 N1 - Lee, PKengne, A-PGreenfield, J RDay, R OChalmers, JHo, K K YEnglandInt J Obes (Lond). 2011 Nov;35(11):1395-403. doi: 10.1038/ijo.2010.284. Epub 2011 Feb 8. N2 -BACKGROUND: Sympathetic activation is an important metabolic adaptation limiting weight gain. Propensity of weight gain associated with beta-blocker therapy in the obese modern population is unknown. OBJECTIVE: To determine whether chronic beta-blocker therapy reduces energy expenditure (EE) and increases body weight. METHODS: 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 beta-blocker and anthropometrically matched controls (n=19) and (ii) three cross-sectional studies comparing body weight, body mass index (BMI) and waist circumference between beta-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). RESULTS: Among weight-matched beta-blocker users, diet-induced thermogenesis, fat oxidation rate and weekly habitual activity were lower by 50% (P<0.01), 32% (P=0.04) and 30% (P<0.01), respectively, compared with controls. In beta-blocker treated patients, the adjusted mean body weight was 9.2 +/- 1.2 kg (P=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 beta-blockers. BMI displayed a similar difference. CONCLUSIONS: EE is reduced and body weight increased in chronic beta-blocker users. We hypothesise that chronic beta-blockade causes obesity by blunting EE.
PY - 2011 SN - 1476-5497 (Electronic)0307-0565 (Linking) SP - 1395 EP - 403 T2 - International Journal of Obesity (Lond) TI - Metabolic sequelae of beta-blocker therapy: weighing in on the obesity epidemic? VL - 35 ER -