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Meta-Analysis
. 2008 Nov;126(6):342-6.
doi: 10.1590/s1516-31802008000600010.

Can sibutramine alter systemic blood pressure in obese patients? Systematic review and meta-analysis

Hernani Pinto de Lemos Jr  1 , Alvaro Nagib Atallah, André Luis Alves de Lemos
Affiliations
Meta-Analysis

Can sibutramine alter systemic blood pressure in obese patients? Systematic review and meta-analysis

Hernani Pinto de Lemos Jr et al. Sao Paulo Med J. 2008 Nov.

Abstract
in English, Portuguese

Context: Systemic arterial hypertension is part of the metabolic syndrome resulting from obesity.

Objective: To evaluate the effect of sibutramine on overweight and obese patients' blood pressure through a systematic review.

Methods: All the studies included needed to be randomized controlled trials. The methodological quality of the selected trials was assessed using the criteria described in the Cochrane Handbook. The participants were overweight and obese patients; the intervention was sibutramine compared with placebo. The primary outcome measurement was systolic and diastolic blood pressure and the secondary measurement was blood pressure. Studies were identified by searching the following sources: Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medline, Cochrane reviews, manual searches, personal communication and contact with the pharmaceutical industry. There were no language, date or other restrictions. Data collection and extraction was performed by two reviewers, who independently obtained the full articles of all eligible papers.

Results: Three meta-analyses were produced: 1) systolic blood pressure outcome (eight studies) did not show statistical significance between sibutramine and placebo: weighted mean difference (WMD) 1.57, confidence interval (CI) -0.03 to 3.18; 2) diastolic blood pressure outcome (ten studies) did not show statistical significance between sibutramine and placebo: WMD 1.13, CI -0.49 to 2.76; 3) blood pressure outcome (two studies) also did not show statistical significance between the groups: relative risk (RR) 0.69, CI 0.07 to 7.01.

Conclusions: The meta-analyses presented in this systematic review show that sibutramine does not have a statistically significant effect on blood pressure, compared with placebo.

CONTEXTO:: Hipertensão arterial sistêmica é parte da síndrome metabólica relacionada à obesidade.

OBJETIVO:: Avaliar o efeito da sibutramina na pressão arterial sistêmica de pacientes com sobrepeso e obesos através de uma revisão sistemática.

MÉTODOS:: Tipos de estudos: todos os estudos devem ser controlados e aleatórios. A qualidade metodológica dos estudos selecionados foi acessada usando os critérios descritos no Cochrane Handbook; participantes: pacientes com sobrepeso e obesos; intervenção: sibutramina comparada com placebo. Desfechos primários: pressão arterial sistólica e diastólica; secundário: pressão arterial. Estratégia de busca: os estudos foram identificados das seguintes fontes: Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medline (Medical Literature Analysis and Retrieval System Online), Cochrane reviews (fontes eletrônicas), manuais, comunicação pessoal e contato com indústria farmacêutica, sem limites. Coleta de dados: dois revisores independentemente obtiveram os artigos completos de todas as publicações elegíveis.

RESULTADOS:: Três metanálises foram realizadas: no desfecho pressão arterial sistólica, com oito estudos, não houve significância estatística para a diferença entre a sibutramina e o placebo, WMD (weighted mean difference) 1.57, intervalo de confiança (IC) de -0,03 a 3,18; no desfecho pressão arterial diastólica, com 10 estudos, também não houve significância estatística na diferença entre a sibutramina e o placebo, WMD 1.13, IC de -0,49 a 2,76) e no desfecho pressão sangüínea com somente dois estudos, também não foi demonstrada diferença estatisticamente significante entre os grupos experimental e controle, risco relativo de 0,69, IC de 0,07 a 7,01.

CONCLUSÃO:: O resultado das metanálises apresentadas nesta revisão mostra que a sibutramina utilizada em pacientes obesos, quando comparada ao placebo, não tem efeito estatisticamente significante na pressão arterial.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1
Figure 1. Systolic blood pressure and sibutramine in obese patients.
Figure 2
Figure 2. Diastolic blood pressure and sibutramine in obese patients.
Figure 3
Figure 3. Diastolic blood pressure, as in Figure 2 but without the study by Hansen et al.
Figure 4
Figure 4. Blood pressure and sibutramine in obese patients.
See this image and copyright information in PMC

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