Two therapies that appear to be effective in promoting weight loss for obese individuals may also help them control their blood pressure, according to two new studies. Presented at the American Society of Hypertension 2012 Scientific Sessions, these studies found that treatment with the extended-release weight-loss pill Qnexa (phentermine/topiramate, slated for an FDA vote in July) or with laproscopic adjustable gastric banding helps to both reduce weight and lower blood pressure.
In the first study, conducted by a researcher at Pennington Biomedical Research Center and colleagues, patients received one of three doses of phentermine/topiramate or a placebo as part of the EQUIP and CONQUER studies. A total of almost 4,000 overweight or obese patients participated. The results showed that patients taking phentermine/topiramate were significantly more likely to lose 5 to 10 percent of their body weight. Furthermore, there were greater reductions in blood pressure when taking the drug, compared to placebo and fewer patients with prehypertension progressed to actual hypertension.
For the second study on laparascopic adjustable gastric banding (Lap-Band, produced by Allergan), a University of California, Irvine researcher analyzed data on over 900 obese patients who received the treatment as part of the Helping Evaluate Reduction in Obesity (HERO) study. Participants had to have a BMI (body mass index) of over 40, or at least 35 if they also had weight-related comorbidities. For this study, researchers tracked patients for six months following surgery.
Patients who received the gastric band lost over 38 pounds on average, amounting to almost 14 percent of their body weight. While the patients average BMI was almost 44 at the time of surgery, it dropped to 38 after six months. Additionally, these patients exhibited significant reductions in blood pressure, and more patients were able to control their blood pressure after six months.
People who are both obese and hypertensive have a much greater risk of disease and mortality, says ACSH's Dr. Gilbert Ross. "Reducing both of these factors, then, is extremely important. And these two methods one pharmaceutical, the other surgical appear to be effective.
And while we re on the topic of hypertension: Some researchers are starting to consider a more aggressive approach to controlling high blood pressure in patients whose condition is resistant to even a regimen of multiple blood pressure medications. About 10 percent of patients with high blood pressure totaling over 7 million people in the U.S. have such drug-resistant hypertension. A new invasive procedure, by Medtronic, takes a different approach: threading a catheter through small arteries to the kidney to extinguish certain overactive nerves that can contribute to high blood pressure. So far, only small studies have examined the procedure, but the patients who underwent it saw their systolic blood pressure (the top number) drop by 33 mm on average, although they still had to take their medications following the treatment. A new study, enrolling over 500 people, will examine whether this more invasive procedure might benefit patients with resistant hypertension.