Pediatr Obes. 2026 May;21(5):e70114. doi: 10.1111/ijpo.70114.
ABSTRACT
BACKGROUND: Antihypertensive class medications are prescribed long-term for adolescents, including for conditions other than hypertension. Evidence on weight effects is limited.
OBJECTIVE: To assess the weight effects of commonly prescribed antihypertensive class medications among adolescents, regardless of clinical indication for use.
METHODS: This retrospective study was conducted using electronic health record (EHR) data from a multi-site US research network. The study cohort included adolescents aged 13.0-19.5 years with ≥ 1 antihypertensive class medication order during 2010-2019. Weight and height documented in the EHR were used to calculate BMI z-scores. Inverse probability weighting with marginal structural models was used to account for selection factors and covariates.
RESULTS: Overall, 23 853 adolescents were prescribed an antihypertensive class medication, including clonidine (prescribed to n = 7491), guanfacine (n = 6411), lisinopril (n = 3584), propranolol (n = 3015), spironolactone (n = 1926), and atenolol (n = 1426). At baseline, 13% had a hypertension diagnosis. At 12 months after medication initiation, the estimated population-level BMI z-score was significantly increased for propranolol (BMI z-score 0.19 [95% CI 0.09, 0.29]) and significantly decreased for lisinopril (-0.06 [95% CI -0.10, -0.01]); clonidine, guanfacine, spironolactone, and atenolol were not associated with a significant change in BMI z-score.
CONCLUSIONS: Most antihypertensive class medications were not associated with statistically significant weight gain when prescribed to adolescents.
PMID:42165095 | DOI:10.1111/ijpo.70114