Sibutramine and its cardiovascular profile.

Sibutramine can produce dose-dependent increases in blood pressure and heart rate, especially during initial treatment. However, the cardiovascular effects of the drug are related to the weight loss achieved: patients who lose 5% or more of initial body weight have a reduction in blood pressure, which correlates with the degree of weight loss. Sibutramine does not exacerbate pre-existing controlled hypertension and treatment has been shown to be safe and effective in these patients. In clinical practice, it is important to observe the recommended exclusion criteria, to monitor blood pressure and heart rate and to adhere to the withdrawal criteria. This should enable the identification of those patients for whom sibutramine is not suitable while permitting the majority of patients to gain clinical benefit from treatment.