Weight gain tied to hypertension in patients on methadone maintenance treatment

The occurrence of hypertension in patients with opioid use disorder receiving methadone maintenance treatment (MMT) is associated with weight gain, reports a study.

Eighty-nine (36.3 percent) patients in this study presented with hypertension. No difference was seen between the hypertension and nonhypertension groups in terms of sex (p=0.6), age (p=0.2), and duration in MMT (p=0.6), but hypertensive participants had higher BMI (27.9 vs 25.6 kg/m²; p=0.001) and fewer positive urine test results for any substance (31.5 percent vs 44.9 percent; p=0.04).

Increased blood pressure (BP) and BMI occurred more frequently among hypertensive patients when compared with their earlier measure (before 11.9 years), independent of methadone dose and serum levels, which dropped significantly over time. No drug abuse correlated with increased BMI and BP.

“Healthy nutrition education at admission to MMT may reduce the incidence of weight gain and hypertension,” the investigators said. [T]herefore, identifying hypertension and offering treatment for this highly prevalent life-threatening condition among middle-age and older patients in MMT is recommended.”

A total of 1,098 MMT patients were identified. Of these, 516 with two or more BP follow-up measures were included in the analysis. Overall, 245 patients were found to have hypertension (BP ≥140/90), detected twice (1 week apart). The investigators then analysed BMI, BP, methadone dose and serum level, and drugs in urine during MMT.