The relationship between body weight and blood pressure.

In adults of Western societies the positive relationship between blood pressure and body weight has often been demonstrated, both cross-sectionally and longitudinally. This correlation is even stronger in children and early adulthood. In most studies in children, the association between age and blood pressure disappears after controlling for weight. Association must be differentiated from causation. It has however been shown in several intervention studies that treatment of obesity by weight loss decreases blood pressure substantially both in hypertensive and normotensive subjects. Although combining results from several intervention trials is difficult this is the only practical way to get an overall estimate of the hypotensive response to be expected from weight reduction. In the randomised controlled intervention studies, conducted in obese hypertensive patients and reviewed in the present meta-analysis, a decrease in body weight by 1 kg resulted in a reduction of systolic and diastolic pressure by 1.2 and 1.0 mmHg, respectively. Blood pressure generally decreased before normal weight was achieved and remained reduced as long as there was no marked regain in body weight. Although a decrease in salt intake during dieting may contribute to the blood pressure lowering effect of weight reduction, also other mechanisms, such as a reduction in plasma renin activity and a decrease in sympathetic tone may also be involved.