Rene T.
Age 49
Height 5'7"
Weight 189 lbs
BP 158/105
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Previous Patient Profile
Stage 2 Hypertension, BMI 30
Profile and History:
Rene T. is 49 years old. She has stage 2 hypertension (BP=158/105).
- At her last appointment, 7 months ago, you put her on enalapril, 5 mg bid, and nifedipine extended-release, 60 mg/day.
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Diagnosis and Identification:
- She is 5'7", weighs 189 lbs and has a BMI of 30.
- It's clear that the antihypertension drugs are helping but, Rene's weight is interfering with their effectiveness.
- A treatment plan to optimize her blood pressure and reduce her cardiovascular risk through weight loss, diet and exercise is advisable.
- A prescription for XENICAL will help Rene reach these goals, particularly if she can be motivated to start.
More on identifying patients at risk
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Counseling:
- Discussing your concerns about Rene's health and reminding her that weight loss in combination with the medications would be effective in both controlling her blood pressure and reducing her cardiovascular risk provides a positive place to start a discussion about weight loss.
- Helping Rene set reasonable initial goals allows her to gain the perspective she needs to be confident that she can achieve these goals.
More on counseling your patient
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Treatment:
- Treatment goals for Rene include weight loss, improved blood pressure and reduced cardiovascular risk.
- A prescription for XENICAL, a 1200-calorie per day diet and a follow-up visit in 6 weeks is advisable. For now, you will leave her other medication dosage schedule the same.
- You can ensure greater compliance by provided Rene with materials about weight
control and XENICAL.
More on treatment and management
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Follow-Up:
At her next visit, Rene has lost 4 lbs. Her BMI is down one unit, and you're seeing the results you want to see with her blood pressure.
More on follow-up care
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Outcomes:
Population with Abnormal (Untreated) Risk Factors at Randomization
Weight Loss with XENICAL Plus Diet: Improved Blood Pressure
- In the population with abnormal blood pressure at baseline (systolic BP >140 mm Hg), the change in systolic blood pressure from randomization to 1 year was greater for patients on XENICAL plus diet (-10.89 mm Hg) than for patients on placebo plus diet (-5.07 mm Hg). Patients with diastolic blood pressure >90 mm Hg on XENICAL plus diet also had greater changes in diastolic blood pressure (-7.9 mm Hg) than those on placebo plus diet did (-5.5 mm Hg).
Population as a Whole
XENICAL Plus Diet: Successful Weight Loss
In clinical trials involving 1064 patients, 69% on XENICAL plus diet lost 3% or more of initial body weight within 3 months, with a mean loss of 13 lbs.18
The mean change in systolic blood pressure was -1.01 mm Hg for patients on XENICAL plus diet and +0.58 mm Hg for patients on placebo plus diet. The mean change in diastolic blood pressure was -1.19 mm Hg for patients on XENICAL plus diet and +0.46 mm Hg for patients on placebo plus diet.
In clinical trials, the overall mean weight loss from randomization to the end of 1 year in the intent-to-treat population was 13.4 lbs in patients treated with XENICAL plus diet versus 5.8 lbs in placebo-treated patients.
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The long-term effects of orlistat on morbidity and mortality associated with obesity have not been established.
The patient depicted here is fictitious and is intended to illustrate an obesity-related comorbidity for which a treatment regimen including XENICAL plus a reduced-calorie diet is appropriate.
Previous Patient Profile
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