Premature large artery stiffening is a major contributor to the development of cardiovascular disease in type 2 diabetes. Intentional weight loss through lifestyle intervention is associated with a reduction in arterial stiffness. Rimonabant is a cannabinoid-1 receptor blocker that reduces body weight and improves the cardiovascular risk profile in obese subjects. The purpose of this study was to examine the effects of rimonabant therapy on arterial function in obese subjects with type 2 diabetes.

Twenty-nine obese subjects (age range 30–72yrs) (13 male, 16 females) with type 2 diabetes (13 insulin-treated) were studied. Twenty subjects were studied before, during and after 6 months therapy with rimonabant in conjunction with dietary and lifestyle advice. Nine subjects received dietary and lifestyle advice only without rimonabant. Arterial function was assessed by measuring aortic and brachial pulse wave velocity (PWV) and augmentation index (Sphygmocor).

After 6 months, Rimonabant therapy led to significant weight loss (mean weight loss 5±4Kg, p<0.0001), improved glycaemia (HbA1c reduction 0.6±1.1%, p<0.05) and lipid profile (HDL cholesterol increase of 0.1±0.1mmol/L, p<0.01). Aortic systolic pressure was lowered by 5±9mmHg (p<0.05) but there were no changes to peripheral blood pressure, augmentation index or aortic PWV.

In conclusion, rimonabant therapy in association with dietary and lifestyle change leads to significant weight loss and improved glycaemic control in obese adults with type 2 diabetes. However, these clinical benefits do not appear to be accompanied by a reduction in arterial stiffness or wave reflection.