Metabolic sequelae of beta-blocker therapy: Weighing in on the obesity epidemic?

Lee, P., Kengne, A. -P., Greenfield, J. R., Day, R. O., Chalmers, J. and Ho, K. K. Y. (2011) Metabolic sequelae of beta-blocker therapy: Weighing in on the obesity epidemic?. International Journal of Obesity, 35 11: 1395-1403. doi:10.1038/ijo.2010.284

Author Lee, P.
Kengne, A. -P.
Greenfield, J. R.
Day, R. O.
Chalmers, J.
Ho, K. K. Y.
Title Metabolic sequelae of beta-blocker therapy: Weighing in on the obesity epidemic?
Formatted title
Metabolic sequelae of β-blocker therapy: Weighing in on the obesity epidemic?
Journal name International Journal of Obesity   Check publisher's open access policy
ISSN 0307-0565
Publication date 2011-11
Sub-type Article (original research)
DOI 10.1038/ijo.2010.284
Volume 35
Issue 11
Start page 1395
End page 1403
Total pages 9
Place of publication London, England, U.K.
Publisher Nature Publishing Group
Collection year 2012
Language eng
Formatted abstract
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<0.01), 32% (P=0.04) and 30% (P<0.01), respectively, compared with controls. In β-blocker treated patients, the adjusted mean body weight was 9.2±1.2 kg (P=0.0002) higher among those attending the diabetes clinic, 17.2±3.2 kg (P=0.004) higher among those attending the hypertension clinic and 5.2±0.7 kg (P=0.0003) higher at baseline among participants in the ADVANCE trial compared with patients not treated with β-blockers. BMI displayed a similar difference.
Conclusions: EE is reduced and body weight increased in chronic β-blocker users. We hypothesise that chronic β-blockade causes obesity by blunting EE.
Keyword β-blocker
Energy expenditure
Diet-induced thermogenesis
Brown adipose tissue
Habitual activity
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
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Created: Thu, 18 Aug 2011, 11:12:21 EST by Matthew Lamb on behalf of School of Medicine