Metabolic sequelae of β-blocker therapy: weighing in on the obesity epidemic

• Published in: International Journal of Obesity 2011-11, Vol.35 (11), p.1395-1403
• Main Authors: Lee, P, Kengne, A.P, Greenfield, J.R, Day, R.O, Chalmers, J, Ho, K.K.Y
• Format: Article
• Language: English
• Subjects: 631/443/319/333/1465; 692/699/2743/393; 692/700/565/2194; Absorptiometry, Photon; Adiposity - drug effects; Adrenergic beta blockers; Adrenergic beta-Antagonists - administration & dosage; Adrenergic beta-Antagonists - adverse effects; Aged; Antihypertensive Agents - administration & dosage; Antihypertensive Agents - adverse effects; Australia - epidemiology; beta-adrenergic antagonists; Biological and medical sciences; Body Mass Index; Body Weight - drug effects; Care and treatment; Case-Control Studies; complications (disease); cross-sectional studies; Diagnosis; Energy Metabolism - drug effects; Epidemiology; Female; General aspects; Health aspects; Health Promotion and Disease Prevention; Humans; hypertension; Hypertension - drug therapy; Hypertension - metabolism; Internal Medicine; Lipid Peroxidation - drug effects; Male; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Middle Aged; Miscellaneous; noninsulin-dependent diabetes mellitus; Obesity; Obesity - chemically induced; Obesity - epidemiology; Obesity - metabolism; original-article; oxidation; patients; Prospective Studies; Public Health; Public health. Hygiene; Public health. Hygiene-occupational medicine; Surveys and Questionnaires; therapeutics; thermic effect of food; Thermogenesis - drug effects; volunteers; Waist Circumference; weight gain
• ISSN: 0307-0565; 1476-5497
• DOI: 10.1038/ijo.2010.284

Background: Sympathetic activation is an important metabolic adaptation limiting weight gain. Propensity of weight gain associated with β-blocker therapy in the obese modern population is unknown. Objective: To determine whether chronic β-blocker therapy reduces energy expenditure (EE) and increases body weight. Methods: We undertook (i) a mechanistic study comparing EE, diet-induced thermogenesis and habitual activity between healthy volunteers (n=11) with uncomplicated hypertension treated with a β-blocker and anthropometrically matched controls (n=19) and (ii) three cross-sectional studies comparing body weight, body mass index (BMI) and waist circumference between β-blocker treated and untreated patients from ambulatory patients attending (a) diabetes outpatient clinic (n=214), (b) hypertension outpatient (n=84) and (c) participants in a multi-centre type 2 diabetes trial (ADVANCE) (n=11140). Results: Among weight-matched β-blocker users, diet-induced thermogenesis, fat oxidation rate and weekly habitual activity were lower by 50% (P