Managing CMR

Managing Cardiometabolic Risk in Abdominally Obese Patients

Pharmacotherapy

Key Points

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  • Orlistat, sibutramine, and rimonabant all promote weight loss and its maintenance over time.
  • Lifestyle changes and drug interventions have an additional impact on weight loss.
  • Rimonabant is the only drug that has been shown to improve the metabolic profile beyond that expected from weight loss alone, likely because it works directly on peripheral metabolic pathways.
  • Rimonabant has been tested specifically in individuals at risk for CVD. Investigation of any weight reduction drug should include at-risk individuals, with special focus on intra-abdominal obesity and its response to treatment.
  • Further study is required to determine the long-term benefits and side effects of pharmacotherapy and its impact on clinical cardiovascular endpoints relevant to obesity-related morbidity and mortality.