Does valsartan (angiotensin II receptor antagonist) cause weight gain?

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Last updated: May 22, 2025View editorial policy

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From the Guidelines

Valsartan is not typically associated with significant weight gain, and most patients can expect a weight-neutral or slightly weight-loss effect while taking this medication. The evidence from large-scale trials such as the Valsartan Heart Failure Trial (Val-HeFT) and CHARM-Added, which involved over 7600 patients with heart failure, does not suggest that valsartan causes significant weight gain 1. In fact, these studies focused on the benefits of valsartan in reducing the risk of heart failure hospitalization and improving symptoms and quality of life, without mentioning weight gain as a common side effect.

Some key points to consider:

  • Valsartan, as an angiotensin II receptor blocker (ARB), can affect kidney function and lead to sodium and water retention in some patients, which may result in modest weight gain 1.
  • However, this weight gain is typically less than 5 pounds and may be due to fluid retention rather than fat accumulation.
  • If significant weight gain (more than 5 pounds in a week) occurs while taking valsartan, especially with swelling in the ankles, feet, or hands, patients should contact their healthcare provider to rule out excessive fluid retention 1.
  • Other factors such as diet, exercise, and concurrent medications can influence weight more significantly than valsartan itself.

It's essential to note that the primary benefits of valsartan, as demonstrated in the CHARM trials and Val-HeFT, include reducing the risk of heart failure hospitalization, improving symptoms and quality of life, and improving exercise capacity 1. Therefore, any potential weight gain associated with valsartan should be weighed against its overall benefits in managing heart failure and other cardiovascular conditions.

From the Research

Valsartan and Weight Gain

  • The study 2 found that valsartan could be effective in controlling blood pressure and achieving weight loss in overweight or obese patients with mild to moderate hypertension.
  • In this study, mean body mass index (BMI) was significantly decreased compared to baseline after 24 weeks of treatment with valsartan.
  • However, the other studies 3, 4, 5, 6 do not provide information on the effect of valsartan on weight gain.
  • It can be noted that the study 2 had patients maintain a 1600-kcal/d diet throughout the study, which may have contributed to the weight loss observed.

Mechanism of Action

  • Valsartan is an angiotensin II antagonist that selectively blocks the binding of angiotensin II to the angiotensin II type 1 receptor 3.
  • This mechanism of action may contribute to its antihypertensive effects, but its impact on weight gain is not well understood.

Clinical Trials

  • The clinical trials 3, 2, 4, 5, 6 demonstrate the efficacy and safety of valsartan in treating hypertension, but only one study 2 provides information on its effect on weight loss.
  • Further research is needed to fully understand the relationship between valsartan and weight gain.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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