Effect of orlistat-induced weight loss on blood pressure and heart rate in obese patients with hypertension

J Hypertens. 2002 Sep;20(9):1873-8. doi: 10.1097/00004872-200209000-00034.


Objective: To investigate the effects of long-term weight management with orlistat on blood pressure in obese hypertensive patients.

Design: A meta-analysis of data from five multicenter, randomized, placebo-controlled studies, conducted in Europe and the USA, was performed.

Patients: Obese adults [body mass index (BMI) 28-43 kg/m(2) ] with uncontrolled diastolic hypertension or isolated systolic hypertension (ISH) were eligible for inclusion.

Interventions: Following a 4-week placebo lead-in period, patients were randomized to orlistat 120 mg or placebo three times daily, in conjunction with a mildly reduced calorie diet for 1 year.

Main outcome measures: Change in body weight was the primary efficacy parameter. Blood pressure, heart rate and systolic workload were assessed as secondary efficacy parameters.

Results: A total of 628 patients were included in the intent-to-treat (ITT) analysis. After 56 weeks, orlistat-treated patients had lost significantly more body weight than placebo recipients (8.0 versus 4.0%; P<0.001). Among patients with ISH, mean systolic pressure was reduced to a significantly greater degree after 1 year with orlistat compared to placebo (-9.4 versus -4.6 mmHg; P= 0.022). Similarly, reductions in mean diastolic pressure in patients with diastolic hypertension were greater with orlistat than with placebo (-7.7 versus -5.6 mmHg; P= 0.017). Weight loss of >or= 10% was associated with significant reductions in blood pressure, heart rate and systolic workload.

Conclusions: Orlistat promotes clinically meaningful weight loss that is associated with significant reductions in blood pressure and heart rate, and may therefore have a role in the management of hypertension in overweight and obese patients.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Obesity Agents / therapeutic use*
  • Blood Pressure
  • Humans
  • Hypertension / etiology*
  • Hypertension / physiopathology
  • Lactones / therapeutic use*
  • Multicenter Studies as Topic
  • Obesity / complications*
  • Obesity / drug therapy*
  • Obesity / pathology
  • Orlistat
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Weight Loss*


  • Anti-Obesity Agents
  • Lactones
  • Orlistat