Heart Medications That Cause Weight Gain

How do heart medications contribute to weight gain?

Heart medications may contribute to weight gain through various ways:

• Increased appetite: You may be hungrier while taking certain medications, causing you to eat more.
• Slowed metabolism: Medications that alter your metabolism may cause you to burn fewer calories, leading to weight gain without dietary changes.
• Fluid retention: Antihypertensives, or medications used to treat high blood pressure, often cause fluid retention and, therefore, weight gain.
• Changes in fat storage: Some medications may influence the distribution of your body fat, and you may see abdominal obesity (central adiposity) or visceral fat buildup.

What causes weight gain for you may depend on your medication and will vary for everyone. Remember, weight gain is temporary and manageable.

Which heart medications are most likely to cause weight gain?

Although some heart medications list weight gain as a common side effect, this won’t be a side effect for everyone. Your doctor should know if weight gain is a risk factor for you and will factor this into their prescription and dosage recommendation.

Here are heart medications likely to cause weight gain.

Beta-blockers

A 2018 Canadian research review found that three beta-blockers may more commonly cause weight gain:

• atenolol
• metoprolol
• propranolol

They may do this by blocking the effects of adrenaline.

The same research review found that while alpha-blockers don’t typically cause weight gain, combining them with beta-blockers, which are more commonly linked to weight gain, may cause weight gain.

Calcium channel blockers

Calcium channel blockers used to treat heart-related conditions are generally considered weight neutral or have no effect on weight.

A common side effect of amlodipine is swelling, which may result in weight gain. If swelling is present, a doctor may recommend alternative medications.

The calcium channel blocker flunarizine, a migraine medication, may also lead to weight gain. Past research has associated it with an increased appetite and up to 8.8 pounds (lb), or 4 kilograms (kg), of weight gain.

Statins

Also known as cholesterol-lowering medications, statins have been shown to potentially cause weight gain through altering leptin expression. The hormone leptin helps regulate body weight and appetite by signaling that you’re full.

A 2018 study that tested atorvastatin’s and simvastatin’s effects on leptin found that they decrease leptin mRNA expression. This means these two statins may cause your fat cells to create less of this hormone.

Less leptin may contribute to an increased appetite and, therefore, weight gain.

Diuretics

Diuretics help your body release extra sodium (salt) and water with proper use, especially if you have high fluid retention levels due to heart failure. Typically, they cause weight loss by helping you lose this water weight.

However, rarely, diuretics may cause edema if taken in the long term or with improper use.

When this happens, it’s called diuretic-induced edema (DIO). DIO causes you to retain more sodium and water, which may contribute to temporary and modest weight gain. This condition, however, is rare.

Vasodilators

Similar to diuretics, vasodilators to increase blood flow in people with high blood pressure may cause fluid retention, which may lead to a temporary weight increase.

Other antihypertensives

Other antihypertensives from different drug classes used to treat heart conditions and associated with weight gain are:

• clonidine
• perindopril
• valsartan
• diltiazem

How much weight gain you may observe is typically small — less than 3.3 lb (1.5 kg) on average for some antihypertensives.

Are there heart medications that don’t cause weight gain?

While several heart-related medications may cause weight gain, some don’t affect weight or have weight loss potential.

Specific to antihypertensives, those that may be weight neutral or cause weight loss are:

• Neutral to weight gain:
  • prazosin
  • irbesartan
  • olmesartan
  • acebutolol
  • amlodipine
  • aliskiren
• Associated with weight loss:
  • enalapril
  • lisinopril
  • ramipril
  • losartan
  • telmisartan
  • timolol
  • chlorthalidone
  • furosemide
  • hydrochlorothiazide
  • indapamide
  • perindopril (also noted to cause weight gain)
  • carvedilol
  • nebivolol

Although these blood pressure medications are associated with weight loss or are weight neutral, it doesn’t mean they’ll have the same effect on you. Everyone will respond to medication differently.

What should you do if you’re gaining weight from heart medication?

If you notice you’re gaining weight from your medication, discuss your concerns with your doctor. Do not stop taking the medication without their approval. They may adjust your dosage or switch your medication.

Stopping your medication without your doctor’s approval may worsen your condition or have severe side effects.

Lifestyle changes can also help minimize, prevent, or manage weight gain from your medications. Try (or continue):

• sleeping for 7 to 9 hours nightly
• exercising 150 minutes weekly, or as you’re able
• eating a balanced diet that consists of fruit, vegetables, and other whole foods
• limiting your alcohol intake, if you drink, to no more than one drink daily for women and two daily for men
• avoiding smoking, if you smoke, or speak with your doctor about a smoking cessation program
• managing any stress in your life
• consider speaking with your doctor about weight loss medications

Your doctor may have other lifestyle recommendations for you, too. A registered dietitian may help you create an eating plan that works for you and other health conditions you may be managing.

Takeaway

Beta-blockers, calcium channel blockers, diuretics, vasodilators, and other medications for heart-related conditions may cause weight gain. Some, such as certain beta-blockers, are more likely to cause weight gain than others.

But many alternatives are available. Speak with your doctor about your concerns. A balanced diet and active lifestyle may help minimize or prevent your risk of weight gain.