title: The Trial of Antihypertensive Interventions and Management (TAIM) study. Adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension.
abstract: This report examines the effect of weight loss, alone and in combination with drugs, on diastolic blood pressure change in the Trial of Antihypertensive Interventions and Management (TAIM), which is a randomized, multicenter, placebo-controlled clinical trial of drug and diet combinations in the treatment of mild hypertension among 787 patients. Diastolic blood pressure drop (11.6 mm Hg) at 6 months among those patients who were randomized to weight reduction and placebo drug treatment was greater among those who lost 4.5 kg or more, than the 7-mm Hg drop for those who lost less than 2.25 kg or for the placebo-treated control group, and it was statistically equivalent to the reduction achieved by 25 mg of chlorthalidone or 50 mg of atenolol (11.1- and 12.4-mm Hg drop, respectively). Weight loss potentiated effects of drugs, with reductions of 18.4 mm Hg, for those patients who were taking atenolol and had a 4.5-kg or more weight loss, and of 15.4 mm Hg, for those patients who were taking chlorthalidone and had at least a 2.25-kg weight loss. We concluded that effective weight loss (greater than or equal to 4.5 kg) lowers blood pressure similarly to low-dose drug therapy and potentiates drug effects, with the apparent 4.5-kg threshold being lowered to 2.25 kg for those patients who receive chlorthalidone.
authors.affiliation: Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY 10461.
authors.forename: S
authors.initials: S
authors.lastname: Wassertheil-Smoller
authors.forename: M D
authors.initials: MD
authors.lastname: Blaufox
authors.forename: A S
authors.initials: AS
authors.lastname: Oberman
authors.forename: H G
authors.initials: HG
authors.lastname: Langford
authors.forename: B R
authors.initials: BR
authors.lastname: Davis
authors.forename: J
authors.initials: J
authors.lastname: Wylie-Rosett
mesh_terms: D001262:Atenolol / Q000627:therapeutic use*; D044383:Black People; D015992:Body Mass Index; D002752:Chlorthalidone / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D015431:Weight Loss / Q000502:physiology*; D044465:White People
chemical_list: D001262:Atenolol; D002752:Chlorthalidone