Abstract P027: Obesity Treatment-Induced Weight Loss Improves Resting Blood Pressure and Reduces Progression from Prehypertension to Hypertension in Overweight/Obese Adults

Abstract

Background: Obesity is associated with increased risk of hypertension (HTN). Weight loss can reduce blood pressure (BP) and prevent progression to HTN. In the CONQUER trial, overweight/obese subjects with ≥2 weight-related comorbidities had significant weight loss over 56 weeks with phentermine plus topiramate extended-release (PHEN/TPM ER) vs placebo when used in combination with a program of lifestyle modifications. Methods: This post hoc analysis of CONQUER evaluated the effects of PHEN/TPM ER on weight, BP, and HTN status over 56 weeks (intent-to-treat population with last observation carried forward). Overweight/obese subjects with normotension (systolic BP/diastolic BP<120/80 mm Hg; 8.7%; n=212), preHTN (120-139/80-89 mm Hg; 19.0%; n=465: both without antiHTN medication use), and HTN (≥140/90 or antiHTN medication use; 72.3%; n=1770) were randomized to placebo, PHEN 7.5 mg/TPM ER 46 mg (7.5/46), or PHEN 15 mg/TPM ER 92 mg (15/92). Results: At week 56, PHEN/TPM ER-treated subjects in all categories (normotension, preHTN, HTN) achieved significant weight loss vs placebo (percentage and absolute; all P <.0001). Systolic BP was improved vs placebo in all categories in subjects receiving PHEN/TPM ER (significant vs placebo in 15/92 group; Table). Fewer subjects with normotension at baseline receiving PHEN/TPM ER progressed to preHTN, and fewer with preHTN at baseline progressed to HTN, vs placebo (Table). A greater percentage of PHEN/TPM ER-treated subjects with preHTN and HTN achieved normotension vs placebo. Most common adverse events in subjects with preHTN and HTN were constipation, dry mouth, and paraesthesia, and in those with normotension were upper respiratory tract infection, dry mouth, and paraesthesia. Conclusion: Overweight/obese subjects treated with PHEN/TPM ER plus lifestyle intervention lost more body weight vs placebo over 56 weeks. This weight loss occurred along with improvements in BP in subjects with normotension, preHTN, and HTN, potentially improving cardiovascular risk.