Appetite-suppressant drugs and the risk of primary pulmonary hypertension
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BACKGROUND: Recently, a cluster of patients was observed in France in whom primary pulmonary hypertension developed in patients exposed to derivatives of fenfluramine in appetite suppressants (anorexic agents), which are used for weight control. We investigated the potential role of anorexic agents and other suspected risk factors for primary pulmonary hypertension. METHODS: In a case-control study, we assessed 95 patients with primary pulmonary hypertension from 35 centers in France, Belgium, the United Kingdom, and the Netherlands and 355 controls recruited from general practices and matched to the patients' sex and age. RESULTS: The use of anorexic drugs (mainly derivatives of fenfluramine) was associated with an increased risk of primary pulmonary hypertension (odds ratio with any anorexic-drug use, 6.3; 95 percent confidence interval, 3.0 to 13.2). For the use of anorexic agents in the preceding year, the odds ratio was 10.1 (95 percent confidence interval, 3.4 to 29.9). When anorexic drugs were used to a total of more than three months, the odds ratio was 23.1 (95 percent confidence interval, 6.9 to 77.7). We also confirmed an association with several previously identified risk factors: a family history of pulmonary hypertension, infection with the human immunodeficiency virus, cirrhosis, and use of cocaine or intravenous drugs. CONCLUSIONS: The use of anorexic drugs was associated with the development of primary pulmonary hypertension. Active surveillance for this disease should be considered, particularly since their use is expected to increase in the near future.
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Starvation, very-low-calorie diets, liquid protein diets, and obesity surgeries are associated with QTc prolongation and increased risk of malignant dysrhythmias, and various pharmacologic agents have limited efficacy or considerable toxicity.
“Certainly, starvation, very-low-calorie diets, liquid protein diets, and obesity surgeries have been associated with prolongation of the QTc interval and increased risk of malignant dysrhythmias (1), and various pharmacologic agents have either limited efficacy or considerable toxicity (70 -72).”
From Obesity and Cardiovascular Disease (2009) · cites this paper as [71]
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Self-citation
- Authors
- Abenhaim, L., Moride, Y., Brenot, F., Rich, S., Benichou, J., Kurz, X., Higenbottam, T., Oakley, C., Wouters, E., Aubier, M., Simonneau, G., & Bégaud, B.
- Affiliations
- Jewish General Hospital (CA)
- Hôpital Antoine-Béclère (FR)
- University of Illinois Chicago (US)
- Centre Hospitalier Universitaire de Liège (BE)
- University of Sheffield (GB)
- Hammersmith Hospital (GB)
- Maastricht University Medical Centre (NL)
- Hôpital Bichat-Claude-Bernard (FR)
- Hôpital Pellegrin (FR)
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 1996-08-29
- Volume
- 335
- Issue
- 9
- Pages
- 609-616
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2329065056
- Cited by
- 1,162
- References
- 26
- Citations by year
- 2026: 7 · 2025: 23 · 2024: 22 · 2023: 21 · 2022: 22 · 2021: 16 · 2020: 16 · 2019: 20 · 2018: 27 · 2017: 29 · 2016: 18 · 2015: 30 · 2014: 27 · 2013: 39 · 2012: 34
- FWCI
- 71.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Pulmonary Hypertension Research and Treatments
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- idiopathic pulmonary arterial hypertension, appetite suppressants, drug-induced pulmonary hypertension, risk factors, HIV infection, liver cirrhosis, cocaine use, intravenous drug use, weight management
- MeSH terms
- Adolescent, Adult, Aged, Appetite Depressants, Belgium, Female, Fenfluramine, France, United Kingdom, Heart Function Tests, Hemodynamics, Humans, Hypertension, Pulmonary, Male, Middle Aged, Netherlands, Prospective Studies, Respiratory Function Tests, Risk Factors, Incidence, Logistic Models, Case-Control Studies
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