Yftach Gepner1, Nir Goldstein2, Ilan Shelef3, Dan Schwarzfuchs3, Hila Zelicha4, Anat Yaskolka Meir4, Gal Tsaban4, Ehud Grossman2,5. 1. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel-Aviv, Israel. gepner@tauex.tau.ac.il. 2. Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, and Sylvan Adams Sports Institute, Tel-Aviv University, Tel-Aviv, Israel. 3. Soroka University Medical Center, Beer-Sheva, Israel. 4. Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. 5. Internal Medicine Wing, The Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Abstract
BACKGROUND: Obesity is associated with elevated blood pressure (BP). In patients with obesity and hypertension, weight loss lowers BP, but the long-term effect of weight loss on BP is less clear. OBJECTIVE: We aimed to assess the effect of long-term weight loss intervention on BP in normotensive and hypertensive subjects. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred seventy-eight subjects (mean age 47.9 ± 9.3 years, 89% male, 56% hypertensive) with abdominal obesity or elevated serum triglycerides and low high-density lipoprotein cholesterol were recruited. INTERVENTION: Eighteen-month weight loss intervention. MAIN MEASURES: Body weight and BP were measured at baseline, after 6 and 18 months. RESULTS: After 6 months of intervention, in the weight loss phase, body mass index (BMI) decreased by an average of -2.2±1.5 kg/m2 (p<0.001) and both diastolic BP (DBP) and systolic BP (SBP) decreased by -2.1±8.8 mmHg and -2.3±12.9 mmHg, respectively (p<0.01 for both). The change in BMI was similar in normotensive and hypertensive subjects (-2.0±1.6 and -2.3±1.5, p = 0.246). However, DBP and SBP decreased significantly (-5.2±7.1 mmHg and -6.2±12.5 mmHg, respectively, p<0.001 for both) in hypertensive subjects, and increased in normotensive subjects (1.8±9.3 mmHg, p = 0.041 and 2.7±11.7 mmHg, p = 0.017, respectively). After 18 months, in the weight maintenance phase, BMI slightly increased (0.9±1.3 kg/m2, p<0.001) but remained significantly lower than at baseline (p<0.0001). Unlike BMI, DBP and SBP increased significantly in hypertensive subjects (p<0.001) and returned almost to baseline levels. CONCLUSION: Weight-loss intervention reduced BP in hypertensive patients, but this was not maintained in the long run. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01530724.
BACKGROUND: Obesity is associated with elevated blood pressure (BP). In patients with obesity and hypertension, weight loss lowers BP, but the long-term effect of weight loss on BP is less clear. OBJECTIVE: We aimed to assess the effect of long-term weight loss intervention on BP in normotensive and hypertensive subjects. DESIGN: Randomized controlled trial. PARTICIPANTS: Two hundred seventy-eight subjects (mean age 47.9 ± 9.3 years, 89% male, 56% hypertensive) with abdominal obesity or elevated serum triglycerides and low high-density lipoprotein cholesterol were recruited. INTERVENTION: Eighteen-month weight loss intervention. MAIN MEASURES: Body weight and BP were measured at baseline, after 6 and 18 months. RESULTS: After 6 months of intervention, in the weight loss phase, body mass index (BMI) decreased by an average of -2.2±1.5 kg/m2 (p<0.001) and both diastolic BP (DBP) and systolic BP (SBP) decreased by -2.1±8.8 mmHg and -2.3±12.9 mmHg, respectively (p<0.01 for both). The change in BMI was similar in normotensive and hypertensive subjects (-2.0±1.6 and -2.3±1.5, p = 0.246). However, DBP and SBP decreased significantly (-5.2±7.1 mmHg and -6.2±12.5 mmHg, respectively, p<0.001 for both) in hypertensive subjects, and increased in normotensive subjects (1.8±9.3 mmHg, p = 0.041 and 2.7±11.7 mmHg, p = 0.017, respectively). After 18 months, in the weight maintenance phase, BMI slightly increased (0.9±1.3 kg/m2, p<0.001) but remained significantly lower than at baseline (p<0.0001). Unlike BMI, DBP and SBP increased significantly in hypertensive subjects (p<0.001) and returned almost to baseline levels. CONCLUSION: Weight-loss intervention reduced BP in hypertensive patients, but this was not maintained in the long run. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01530724.
Authors: Julie S Pedersen; Christian Borup; Morten Damgaard; Vindhya D Yatawara; Andrea K Floyd; Niels Gadsbøll; Peter K Bonfils Journal: Scand J Clin Lab Invest Date: 2016-12-01 Impact factor: 1.713
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