A review of existing research confirms that the weight-loss drug Meridia raises blood pressure, posing a risk to obese patients who hope to reduce high blood pressure by shedding pounds.

High blood pressure is a condition that contributes to 7 million deaths worldwide each year.

Many doctors assume that patients automatically lower their blood pressure when they become thinner, but that is not necessarily the case when they use drugs to lose weight, said review lead author Dr. Andrea Siebenhofer.

The review authors examined research regarding three weight-loss drugs, orlistat, sibutramine and rimonabant. They looked for studies that lasted at least six months and compared patients with high blood pressure who took one of the drugs to those who took a placebo.

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The researchers conducted a meta-analysis by combining the studies and adjusting the statistical results to account for their sizes.

The diastolic blood pressure levels of patients who took sibutramine rose by 3.2 mm Hg, according to the meta-analysis.

Blood pressure is measured in millimeters of mercury (mm Hg), and expressed with two numbers, for example, 120/80 mm Hg. The first number (systolic pressure) is the pressure when the heart beats while pumping blood. The second number (diastolic pressure) is the pressure in large arteries when the heart is at rest between beats.

High blood pressure is defined as having a systolic and diastolic blood pressure greater than 140 and 90 mmHg.

The review of sibutramine research had some limitations. The review authors only looked at two of the four studies into the drug because they believed the other two did not meet the criteria they had set for inclusion in the meta-analysis.

In addition, the researchers reported that the two studies they did include failed to provide enough information to allow them to calculate how the drug affected systolic blood pressure.

Dr. Raj Padwal, an assistant professor at the University of Alberta in Canada, said the weight-loss drugs only result in modest amounts of weight loss, typically 6 to 11 pounds. A large study is underway to see if sibutramine affects death rates in patients.

Only about 2 percent of patients continue to use the drugs after two years and many find the amount of weight lost disappointing, Padwal said. Side effects are also a problem, orlistat can cause loose stools, for instance, and the drugs are expensive. There are no magic pills, he added.

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References:
1. Siebenhofer A, et al. Long-term effects of weight-reducing drugs in hypertensive patients. Cochrane Database of Systematic Reviews 2009, Issue 3.

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