Related Experiment Video
Updated: Aug 13, 2026

Multidisciplinary Approach to Obesity Management: A Case Report
Published on: May 30, 2025
[Antihypertensive drug utilization in obese patients]
Peter Bramlage1, Carsten Bramlage, Wilhelm Kirch
1Institut für Klinische Pharmakologie, Technische Universität Dresden, Dresden. peter.bramlage@mailbox.tu-dresden.de
Insights
Obese patients with hypertension often receive combination drug therapy, with ACE inhibitors and diuretics most frequently prescribed. However, current treatment strategies may not adequately control blood pressure, necessitating optimized combination regimens.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Context:
- Obesity and arterial hypertension are prevalent, often co-occurring conditions.
- Effective blood pressure management in obese hypertensive patients remains a challenge.
- Limited recent data exist on antihypertensive prescribing patterns in primary care for this population.
Purpose:
- To analyze antihypertensive drug prescription patterns in obese patients with arterial hypertension.
- To identify preferred drug classes, commonly used substances, and dosing strategies.
- To evaluate the adequacy of current pharmacotherapy for blood pressure control in this demographic.
Summary:
- A nationwide observational study analyzed data from over 70,000 hypertensive patients.
- Antihypertensive pharmacotherapy for obese patients showed variation in drug selection but less in dosage.
- Drug combinations, particularly ACE inhibitors and diuretics, were commonly used.
Impact:
- Current antihypertensive drug availability and prescription practices may be insufficient for adequate blood pressure control in obese patients.
- Optimized combination therapy, including reduced doses of certain agents and high doses of RAS inhibitors, could enhance efficacy and reduce side effects.
- Findings highlight the need for improved treatment strategies for managing hypertension in the obese population.
Background And Purpose:
Obesity and arterial hypertension are epidemic and often seen in combination. In spite of the frequency and the difficulties in treating these patients to goal, there are no recent data on the prescription of antihypertensive drugs in primary care in this patient population.
Material And Methods:
Therefore, the data of a nationwide observational study from 2004 were evaluated in which more than 70,000 patients with arterial hypertension were investigated. It was documented, which antihypertensive classes are preferred in obese patients, which are the most often used substances and how these are dosed.
Results:
(1) Antihypertensive pharmacotherapy of obese patients is differentiated in terms of substances used, but less in terms of dosage. (2) Combinations of drugs are more often used to control the blood pressure of these patients and ACE inhibitors and diuretics are most often preferred.
Conclusion:
These results show that the availability of a number of effective antihypertensive drugs is not sufficient to secure an adequate control of blood pressure. The timely combination of antihypertensive drugs in reduced dose (alpha-blockers, beta-blockers, diuretics, and calcium antagonists) in combination with high doses of agents blocking the renin-angiotensin system (RAS) could improve the efficacy while reducing side effects.
Related Concept Videos
Drug Dosing: Obese Patients
Pharmacokinetics in Obese Patients: Drug Absorption and Distribution
Pharmacokinetics in Obese Patients: Drug Metabolism and Excretion
Hypertension IV: Drug Therapy and Lifestyle Modifications
Antihypertensive Drugs: Vasodilators
Antihypertensive Drugs: Potassium-Sparing Diuretics