The American Journal of Medicine
Volume 120, Issue 7 , Pages 610-615, July 2007

Body Weight Changes with β-Blocker Use: Results from GEMINI

  • Franz H. Messerli, MD

      Affiliations

    • St. Luke’s-Roosevelt Hospital Center, New York City
    • Corresponding Author InformationRequests for reprints should be addressed to Franz H. Messerli, MD, St. Luke’s-Roosevelt Hospital Center, Cardiology 3B-30, 1000 10th Ave., New York, NY 10019.
    • ,
  • David S.H. Bell, MB

      Affiliations

    • University of Alabama, Birmingham
    • ,
  • Vivian Fonseca, MD

      Affiliations

    • Tulane University, New Orleans, La
    • ,
  • Richard E. Katholi, MD

      Affiliations

    • St. John’s Hospital, Springfield, Ill
    • ,
  • Janet B. McGill, MD

      Affiliations

    • Washington University School of Medicine, St. Louis, Mo
    • ,
  • Robert A. Phillips, MD, PhD

      Affiliations

    • University of Massachusetts Memorial Medical Center and Medical School, Worcester
    • ,
  • Philip Raskin, MD

      Affiliations

    • University of Texas, Dallas
    • ,
  • Jackson T. Wright Jr., MD, PhD

      Affiliations

    • Case Western Reserve University, Cleveland, Ohio
    • ,
  • Sripal Bangalore, MD

      Affiliations

    • St. Luke’s-Roosevelt Hospital Center, New York City
    • ,
  • Fred K. Holdbrook, PhD

      Affiliations

    • GlaxoSmithKline, Philadelphia, Pa
    • ,
  • Mary Ann Lukas, MD

      Affiliations

    • GlaxoSmithKline, Philadelphia, Pa
    • ,
  • Karen M. Anderson, PhD

      Affiliations

    • GlaxoSmithKline, Philadelphia, Pa
    • ,
  • George L. Bakris, MD

      Affiliations

    • Rush University Medical Center, Chicago, Ill
    • ,
  • GEMINI Investigators

Abstract 

Purpose

Patients with type 2 diabetes are commonly overweight, which can contribute to poor cardiovascular outcomes. β-blockers may promote weight gain, or hamper weight loss, and are a concern in high-risk patients. The current analysis of the Glycemic Effect in Diabetes Mellitus: Carvedilol-Metoprolol Comparison in Hypertensives (GEMINI) trial evaluates the effects of carvedilol and metoprolol tartrate on weight gain in patients with type 2 diabetes and hypertension.

Methods

This prespecified secondary analysis of the GEMINI study (n=1106) evaluated change in body weight after 5 months.

Results

Mean (±SE) baseline weights were 97.5 (±20.1) kg for carvedilol and 96.6 (±20.1) kg for metoprolol tartrate. Treatment difference (c vs m) in mean (±SE) weight change from baseline was −1.02 (±0.21) kg (95% confidence interval [CI], −1.43 to −0.60; P <.001). Patients taking metoprolol had a significant mean (±SE) weight gain of 1.19 (±0.16) kg (P <.001); patients taking carvedilol did not (0.17 [±0.19] kg; P =.36). Metoprolol tartrate-treated patients with body mass index (BMI) >30 kg/m2 had a statistically significant greater weight gain than comparable carvedilol-treated patients. Treatment differences (c vs m) in the obese (BMI >30 kg/m2) and morbidly obese groups (BMI >40 kg/m2) were −0.90 kg (95% CI, −1.5 to −0.3; P =.002) and −1.84 kg (95% CI, −2.9 to −0.8; P =.001), respectively. Pairwise correlation analyses revealed no significant associations between weight change and change in HbA1c, HOMA-IR, or blood pressure.

Conclusions

Metoprolol tartrate was associated with increased weight gain compared to carvedilol; weight gain was most pronounced in subjects with hypertension and diabetes who were not taking insulin therapy.

Keywords: β-blockers, Body Mass Index (BMI), Carvedilol, Diabetes, Hypertension, Metoprolol, Weight

 

PII: S0002-9343(06)01261-7

doi:10.1016/j.amjmed.2006.10.017

The American Journal of Medicine
Volume 120, Issue 7 , Pages 610-615, July 2007

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