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Hypertension, Vol 19, 393-399, Copyright © 1992 by American Heart Association

ARTICLES

Effect of antihypertensive therapy on weight loss. The Trial of Antihypertensive Interventions and Management Research Group

BR Davis, A Oberman, MD Blaufox, S Wassertheil-Smoller, CM Hawkins, JA Cutler, N Zimbaldi and HG Langford
Coordinating Center for Clinical Trials, University of Texas School of Public Health, Houston.

We report the effect of weight changes of the type of antihypertensive medication prescribed in a trial of the relative efficacy of drug and dietary measures in mild hypertension. The Trial of Antihypertensive Interventions and Management studied 878 mildly hypertensive individuals randomly assigned, in a 3 x 3 design, to no diet change, weight loss, or a low sodium-high potassium diet and to placebo, 25 mg chlorthalidone, or 50 mg atenolol. The type of drug prescribed affected weight change with all diets. The drug effect on weight change, present in all groups at 6 months, was most pronounced in those randomly assigned to the weight loss diet, where the placebo group lost 4.4 kg, the atenolol group lost 3.0 kg, and the chlorthalidone group lost 6.9 kg. The group differences were attenuated but persisted at 24 months. We suggest that the antihypertensive drug prescribed affects the success of a conjoint weight loss program and speculate that the difference between the drugs may be due to their intrinsic effects on the sympathetic nervous system and related metabolic changes.

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