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Metabolic sequelae of β-blocker therapy: weighing in on the obesity epidemic?
MedLine Citation:
PMID:  21304487     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Background: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.Objective:To determine whether chronic β-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 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).Results:Among weight-matched β-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 β-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 β-blockers. BMI displayed a similar difference.Conclusions:EE is reduced and body weight increased in chronic β-blocker users. We hypothesise that chronic β-blockade causes obesity by blunting EE.International Journal of Obesity advance online publication, 8 February 2011; doi:10.1038/ijo.2010.284.
Authors:
P Lee; A-P Kengne; J R Greenfield; R O Day; J Chalmers; K K Y Ho
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-08
Journal Detail:
Title:  International journal of obesity (2005)     Volume:  -     ISSN:  1476-5497     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101256108     Medline TA:  Int J Obes (Lond)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1] Department of Endocrinology, St Vincent's Hospital, Sydney, New South Wales, Australia [2] Pituitary Research Unit, Garvan Institute of Medical Research, Sydney, New South Wales, Australia [3] Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.
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