[Weight reduction improves high blood pressure and microalbuminuria in hypertensive patients with obesity].

We investigated the effect of weight reduction on blood pressure, microalbuminuria and renal function in hypertensive patients with obesity for over 12 months. Twenty-five patients with a body mass index (BMI) of over 25 were prescribed low calorie diet (25 kcal/kg). All patients had mild hypertension and microalbuminuria. They were classified into 2 groups after 12 months. Group A consisted of 10 patients who had a weight loss of at least 5%. Group B consisted of 15 patients who did not have any weight loss. The following results were obtained. (1) The percentage of patients with hyperfiltration (GFR; more than 140 ml/min) was 20%. (2) Blood pressure, fasting plasma insulin level, urinary sodium and albumin excretion rate were significantly decreased in Group A. On the other hand, these changes were not observed in Group B. (3) Reduction in mean arterial blood pressure significantly correlated with the fall in body weight. (4) Renal function did not change during the study period in both groups. (5) Urinary albumin excretion rate significantly correlated with weight reduction, decrease in blood pressure and fasting insulin levels. Blood pressure and urinary albumin excretion rate in hypertensive patients with obesity significantly decreased with weight reduction. Probably, weight loss improves insulin resistance and decrease in the plasma insulin level causes a reduction in blood pressure and urinary albumin excretion rate.