Orlistat and cardiovascular risk profile in hypertensive patients with metabolic syndrome: the ARCOS study

Weight loss improves metabolic abnormalities and reduces cardiovascular risk in obese hypertensive patients. To evaluate the impact of a sustained weight loss on coronary risk, 181 hypertensive patients with metabolic syndrome underwent to orlistat therapy, 120 mg, t.i.d., plus diet for 36 weeks. Du...

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Detalles Bibliográficos
Autores: Zanella, Maria Teresa [UNIFESP], Uehara, Marcelo Hiroshi [UNIFESP], Ribeiro, Artur Beltrame [UNIFESP], Bertolami, Marcelo, Falsetti, Ana Claudia, Yunes, Mirela A.
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2006
País:Brasil
Institución:Universidade Federal de São Paulo (UNIFESP)
Repositorio:Repositório Institucional da UNIFESP
Idioma:inglés
OAI Identifier:oai:repositorio.unifesp.br:11600/3047
Acceso en línea:http://dx.doi.org/10.1590/S0004-27302006000200023
http://repositorio.unifesp.br/handle/11600/3047
Access Level:acceso abierto
Palabra clave:Central obesity
Orlistat
Weight reduction
Cardiovascular risk
Framingham risk score
Obesidade central
Redução de peso
Risco cardiovascular
Score de risco de Framingham
Descripción
Sumario:Weight loss improves metabolic abnormalities and reduces cardiovascular risk in obese hypertensive patients. To evaluate the impact of a sustained weight loss on coronary risk, 181 hypertensive patients with metabolic syndrome underwent to orlistat therapy, 120 mg, t.i.d., plus diet for 36 weeks. During therapy, Framingham risk scores (FRS) were calculated for determination of coronary heart disease risk in ten years. Body mass index decreased from 35.0 ± 4.2 to 32.6 ± 4.5 kg/m² (p< 0.0001) and waist circumference from 108.1 ± 10.1 to 100.5 ± 11.1 cm (p< 0.0001), at the end of the study period (week 36). Systolic and diastolic blood pressure showed reductions after the two first weeks, which were maintained up to the end of the study. A clear shift to the left in FRS distribution curve occurred at the end of the study, compared to baseline, indicating a reduction in coronary risk. Over all patients at risk, 49.2% moved to a lower risk category. A weight loss > 5% occurred in 64.6% of all patients, associated with improvement in glucose metabolism. Among those with abnormal glucose metabolism, 38 out 53 patients (71.7%) improved their glucose tolerance (p< 0.0005). In conclusion, long-term orlistat therapy helps to reduce and maintain a lower body weight, decreasing risk of coronary disease and improving glucose metabolism, thus protecting against type 2 diabetes.