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Blood pressure increasing effect of sibutramine in obese patients |
Summary
Background The prevalence of obesity is increasing, and as sibutramine is more prescribed, it requires a better understanding of its effects on blood pressure, through a systematic review of all eligible studies. Objectives: the aim this review is to assess the influence of the use of sibutramine in obese patients with or without antihypertensive drugs. Search strategy: The studies will be identified from the following sources: LILACS, MEDLINE, Cochrane reviews, manual searches, personal communication, contact with pharmaceutical industry. There are no limits about language, date, or other restrictions. Selection criteria: types of studies: all studies must be randomized controlled trials using the criteria described in the Cochrane Handbook, adequacy of allocation concealment: types A and B. Types of interventions: sibutramine compared with placebo. Types of outcome measures: systolic and diastolic blood pressure. Data collection & analysis: two reviewers will independently screen the abstracts of all publications, obtained by the search strategy. Quality assessment: methodological quality of the trials included in this review will be assessed using the criteria described in the Cochrane Handbook (Clarke, 2002). Reviewers conclusions: The sibutramine doesnt affect the blood pressure of obese patient.
Abstract
Prevalence of obesity and its co morbidities has increased over the world (Hodge AM, 1994). Abdominal obesity is resulting in the so-called metabolic syndrome with an increased risk of cardiovascular disease (Kissebach AH, 1982; Larsson B, 1984). Sibutramine is a tertiary amine initially developed as an antidepressant medication. Subsequent studies showed a significant effect of the drug on weight loss due its satietogenic and calorigenic effects (Hansen DL, 1999; James WPT, 2000). The use of sibutramine is associated with an increase in satiety scores and a lack of decline in 24-hour energy expenditure (Hansen DL, 1999;Seagle HM, 1998) which induces weight loss. Sibutramine blocks serotonin, dopamine, and nor adrenaline uptake (Grundlah C, 1997) and the presence of high adrenergic activity may interfere with the benefits resulting from weight loss, and might increase systolic and diastolic blood pressure. Research question: Does sibutramine, used in obese patients, increase systolic and diastolic blood pressure? Description of the studies: 1)Apfelbaum M: published in American Journal of Medicine, 1999. Interventions: Sibutramine 10 mg once daily vs placebo. 2)Bouke PH: published in Cardiology, 2000. Interventions: Sibutramine 10 mg vs placebo. 4) Fanghanel G : published in International Journal Of Obesity, 2000.Interventions: sibutramine 10 mg vs placebo. 5)Faria AN : published in Arq. Bras. Cardiol., 2002.Interventions: sibutramine 10 mg vs placebo. 7)Fujioka K: published in Diabetes, Obesity and Metabolism, 2000.Interventions: Sibutramine vs placebo. 8)Hansen DL: published in International Journal of Obesity, 1999.Participants: sibutramine 15 mg or placebo. 9) James WPT: published in The Lancet, 2000. Interventions: sibutramine or placebo. 10) Srameek JJ published in Journal of Human Hypertension, 2002. Interventions: sibutramine 20 mg or placebo. Zannad F: published in American Heart Journal, 2002. Interventions: sibutramine 10 or 15 mg daily vs placebo. Conclusions: All the data of the eligible studies were put in it analyzes and they dont show statistical difference between the sibutramine and the placebo in relation to systolic and diastolic blood pressure. The sibutramine, in spite of their adrenergic effects, doesnt alter the obese patients blood pressure.
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