Should Patients' Weight Affect the Choice of Antihypertensive Therapy?

In a subanalysis of ACCOMPLISH trial data, overweight or obesity was associated with improved survival in one treatment arm, but not the other.

The obesity paradox suggests that obesity is protective in high-risk hypertensive patients (Am J Med 2007; 120:863). In this prespecified subanalysis from the industry-sponsored ACCOMPLISH trial (JW Cardiol Dec 3 2008), investigators examined whether body weight affects outcomes of antihypertensive therapy. Participants randomized to a single-pill combination of either benazepril and hydrochlorothiazide or benazepril and amlodipine were stratified according to body-mass index (BMI) as follows: obese (BMI, ≥30; n=5709), overweight (BMI, ≥25 to <30; n=4157), or normal weight (BMI, <25; n=1616). The primary endpoint was cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke, adjusted for age, sex, diabetes, previous cardiovas…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

Should Patients' Weight Affect the Choice of Antihypertensive Therapy?

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Reviewing Author