Xenical/alli and Meridia Help Adults Lose Weight but
Just One Lowers Blood Pressure, Too
Those fighting high blood pressure most successful with orlistat (alli/Xenical) or just diet
March 24, 2008 – Although orlistat, sold as alli or
Xenical, and sibutramine (Medidia) both appear to help adults lose
weight, orlistat or just a weight-loss diet are best for losing weight
and lowering blood pressure, according to analysis of previously
published studies reported in the March 24 issue of the JAMA/Archives
journals.
High blood pressure (hypertension) is a major risk
factor for cardiovascular disease and is responsible for approximately 7
million deaths worldwide each year.
But, lowering blood pressure levels in those with
hypertension has been shown to reduce cardiovascular risk, with
corresponding decreases in illness and death.
"Weight reduction is recommended in major
guidelines as an initial intervention in the treatment of hypertensive
patients," the authors write.
"Among the possible means of reducing body weight
are lifestyle modifications and pharmacologic and invasive
interventions."
Karl Horvath, M.D., of the Medical University of
Graz, Australia, and colleagues performed a meta-analysis of 48 articles
that were published before March 2007 and analyzed weight-loss
interventions for patients with hypertension.
Of those studies, 38 assessed diet and 10 focused
on medications for weight loss, including five evaluating orlistat and
five assessing sibutramine.
More About the Weight-Loss
Medications
About Sibutramine
Sibutramine is used in combination with a reduced calorie diet
and exercise to help people who are overweight lose weight and
maintain their weight loss.
Sibutramine is in a class of medications called appetite
suppressants. It works by acting on appetite control centers in
the brain to decrease appetite. Sibutramine comes as a capsule
to take by mouth. It is usually taken with or without food once
a day.
Orlistat (prescription and nonprescription) is used with an
individualized low-calorie, low-fat diet and exercise program to
help people lose weight.
Prescription orlistat is used in overweight people who may also
have high blood pressure, diabetes, high cholesterol, or heart
disease. Orlistat is also used after weight-loss to help people
keep from gaining back that weight. Orlistat is in a class of
medications called lipase inhibitors. It works in the intestines
by blocking absorption of some of the fat in foods eaten. This
unabsorbed fat is then removed in stools from the body.
Orlistat comes as a capsule and a nonprescription capsule to
take by mouth. It is usually taken three times a day with each
main meal that contains fat.
Brand names: Orlistat is marketed over-the-counter as alli by
GlaxoSmithKline and also under the trade name Xenical by Roche.
No relevant articles were located regarding the
weight loss drug rimonabant or evaluating surgical weight reduction.
"Patients assigned to weight loss diets, orlistat
or sibutramine reduced their body weight more effectively than did
patients in the usual care/placebo groups," the authors write.
"Reduction of blood pressure was higher in patients
treated with weight loss diets or orlistat."
Sibutramine treatment, however, did not lower
overall blood pressure and appeared to increase systolic (top number)
blood pressure.
"A reduction in body weight of approximately 8.8
pounds (4 kilograms) was necessary to achieve a reduction of
approximately 6 milligrams of mercury in systolic blood pressure with
dietary treatment and of approximately 2.5 milligrams of mercury with
orlistat," the authors write.
"None of the studies provided data to answer the
question whether risk of mortality [death] or other patient-relevant end
points can be lowered by weight reduction."
