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- Title
Sympathetic Vasomotor Tone Determines Blood Pressure Response to Long-Term Sibutramine Treatment.
- Authors
Heusser, Karsten; Engeli, Stefan; Tank, Jens; Diedrich, Andre; Wiesner, Susanne; Janke, Juergen; Luft, Friedrich C.; Jordan, Jens
- Abstract
Context: The serotonin and norepinephrine transporter inhibitor sibutramine is a widely used antiobesity drug. In acute studies, the peripheral sympathomimetic effect of sibutramine was counteracted by a central sympatholytic action. Objective: The objective was to test the hypothesis that blood pressure responses to long-term sibutramine therapy may be related to sympathetic nerve traffic before treatment in a prospective open-label study in an academic clinical research center. Patients: This study comprised 20 obese subjects (body mass index, 30–40 kg/m2; age, 30–57 yr) receiving 5 d of placebo treatment followed by open-label 15 mg/d sibutramine and hypocaloric diet over 12 wk. Main Outcome Measures: Body weight, blood pressure, heart rate, muscle sympathetic nerve activity (MSNA) (microneurography), plasma catecholamines, and adipose tissue gene expression were measured. Results: Open-label sibutramine treatment decreased body weight 4.1 kg (P < 0.01) and MSNA 17 bursts per minute (P = 0.001), and increased diastolic blood pressure 3 mm Hg (P < 0.05) and heart rate 8 bpm (P < 0.01). The change in blood pressure with sibutramine treatment was inversely correlated with initial MSNA (r2 = 0.34; P < 0.01). Chronic sibutramine treatment increased adrenoreceptor gene expression and plasma catecholamines. Conclusions: The blood pressure response to sibutramine treatment is related to initial MSNA so that subjects with higher MSNA exhibit a smaller increase or even a decrease in blood pressure. The phenomenon might be explained by a sustained reduction in central sympathetic activity with sibutramine treatment.
- Publication
Journal of Clinical Endocrinology & Metabolism, 2007, Vol 92, Issue 4, p1560
- ISSN
0021-972X
- Publication type
Article
- DOI
10.1210/jc.2006-2499