Treatment with orlistat reduces cardiovascular risk in obese patients

Objective To study the efficacy of orlistat, as an adjunct to dietary modif ication, in weight reduction and modification of cardiovascular risk factor s in obese patients after 1 year of treatment. Design A total of 3132 obese patients (body mass index 28-43 kg/m(2)) were evaluated in an analysis of pooled data from five randomized, double-blind, placebo-controlled trials of orlistat in conjunction with a hypocaloric di et. Ail studies included a 4-week, single-blind, placebo lead-in period dur ing which patients followed a mildly hypocaloric diet, after which they wer e randomized to double-blind treatment with orlistat 120 mg three times a d ay (tid) or placebo for 1 year. Results After 1 year, orlistat 120 mg tid produced significantly more weigh t loss than placebo (9.2% vs 5.8%; P< 0.001). Furthermore, a greater propor tion of orlistat-treated patients lost >5% or >10% of their initial body we ight compared to placebo (69.6% vs 51.9%; P< 0.001 and 42.1% vs 22.7%; P< 0 .001, respectively). Improvements in cardiovascular risk factors were obser ved during a 4-week placebo lead-in period. However, following randomizatio n, orlistat-treated patients had significantly greater improvements than pl acebo-treated patients in several lipid parameters including total choleste rol, low-density lipoprotein-cholesterol, triglycerides, and apolipoprotein B. In addition, orlistat had a beneficial effect on oral glucose tolerance tests status, waist circumference and systolic and diastolic blood pressur e. Orlistat was well tolerated and had a similar safety profile to placebo. I Hypertens 1998, 16:2013-2017 (C) 1998 Lippincott Williams & Wilkins.