Body weight changes with β-blocker use:: Results from GEMINI

PURPOSE: Patients with type 2 diabetes are commonly overweight, which can contribute to poor cardiovascular outcomes. beta-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/m(2) had a statistically significant greater weight gain than comparable carvedilol-treated patients. Treatment differences (c vs m) in the obese (BMI > 30 kg/m(2)) and morbidly obese groups (BMI > 40 kg/m(2)) 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 HbA(1c), 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. (c) 2007 Elsevier Inc. All rights reserved.