Evidence map›Paper›PMID 41023301›Full record

Observational studyJournal of general internal medicine2026

Emulation of a Target Trial of Antihypertensive Medications on Weight Change.

Pi-I D Lin, Sheryl L Rifas-Shiman, Joshua Petimar, Han Yu, Matthew F Daley, David M Janicke, William J Heerman, L Charles Bailey, Carlos Maeztu, Kristina H Lewis and 2 more

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Long-term outcomes associated with continued use of ARBs versus CCBs in older adults: a landmark cohort study.Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Pi-I D LinDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Sheryl L Rifas-ShimanDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Joshua PetimarDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Han YuDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Matthew F DaleyInstitute for Health Research, Kaiser Permanente Colorado, Aurora, CO, USA.
David M JanickeDepartment of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
William J HeermanDepartment of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA.
L Charles BaileyApplied Clinical Research Center, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Carlos MaeztuDepartment of Health Outcomes and Biomedical Informatics, University of Florida, Gainesville, FL, USA.
Kristina H LewisDepartment of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Jessica G YoungDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
Jason P BlockDivision of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. jblock1@mgb.org.ORCID 0000-0001-7660-9064

Funding

Medications and Weight Gain in PCORnet: The MedWeight StudyR01DK120598 · NIDDK · HARVARD PILGRIM HEALTH CARE, INC. · PI BLOCK, JASON PERRY · 2020 to 2023
$2.9M
NIDDK NIH HHS R01 DK120598NIDDK NIH HHS R01DK120598
6 · The paper itself

Abstract

backgroundWeight gain after starting antihypertensive medications is a frequent concern for patients, but there is limited data on expected weight change after initiation of these medications. A comparative effectiveness trial to evaluate this outcome would not be feasible.

objectiveTo estimate and compare average weight change under initiating and adhering to commonly prescribed, first-line antihypertensive medications as monotherapy by emulating a target trial.

designRetrospective observational cohort study over 24 months of follow-up using electronic health records (EHR).

participants141,260 patients prescribed one of seven antihypertensives between 2010 and 2019 across 8 US health systems. MAIN OUTCOME AND MEASURES: We examined mean weight change associated with initiation of and adherence to amlodipine, atenolol, hydrochlorothiazide, losartan, metoprolol, or propranolol, relative to lisinopril, at 6, 12, and 24 months after initiation. To adjust for baseline confounding and informative outcome measurement, we used inverse probability weighting with repeated outcome marginal structural models. KEY

resultsAfter baseline and time-varying covariate adjustment, initiation of and adherence to lisinopril were associated with mean weight loss at 6 months (- 0.69 kg, 95% CI - 0.92, - 0.47), 12 months (- 0.58 kg, 95% CI - 1.05, - 0.30), and 24 months (- 1.121 kg, 95% CI - 2.013, - 0.46). Compared to lisinopril, the estimated 6-month weight change was higher for patients prescribed hydrochlorothiazide (0.68 kg, 95% CI 0.31, 1.04), losartan (0.54 kg, 95% CI 0.17, 0.93), metoprolol (1.38 kg, 95% CI 0.95, 1.76), and propranolol (1.03 kg, 95% CI 0.346, 1.62). At 12 months, metoprolol (1.74 kg, 95% CI 1.03, 2.41) and propranolol (1.72 kg, 95% CI 0.06, 3.235) continued to show higher weight change compared to lisinopril.

conclusionWe observed small differences in weight change across antihypertensive medications, with lisinopril leading to weight loss and metoprolol and propranolol to modest weight gain. Clinicians should consider potential weight gain when selecting antihypertensive medications.

Indexed as

Antihypertensive AgentsHypertensionWeight GainWeight LossAdultAgedCohort StudiesFemaleFollow-Up StudiesHumansLisinoprilMaleMetoprololMiddle AgedRetrospective StudiesAntihypertensive AgentsLisinoprilMetoprololElectronic health recordsEpidemiologyHypertensionTarget trialWeight

Identifiers

PMID41023301
PMCPMC13009417

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.