title: The effect of weight loss intervention on antihypertensive medication requirements in the hypertension Optimal Treatment (HOT) study.
abstract: Obesity is a significant risk factor for hypertension and the cardiovascular sequelae of hypertension. Weight loss has been shown to be effective in lowering blood pressure in overweight individuals. The purpose of this study was to show the impact of a weight loss intervention on overall medication requirements for obese, hypertensive patients. This was a substudy of the Hypertension Optimal Treatment (HOT) study. HOT study patients who had a body mass index > or =27 kg/m2 were randomized to receive either the weight loss intervention, which included dietary counseling and group support, or to serve as the control group. Patients' weights and number of medication steps (per HOT protocol) required to achieve target diastolic blood pressure were measured at 3, 6, 12, 18, 24, and 30 months. Patients in the weight loss group lost significantly more weight than the control group only at 6 months (-3.2+/-4.3 v. -1.8+/-2.7 kg [mean +/- SD] for weight loss group versus control, respectively, P = .05). The weight loss group tended to regain weight after the first 6 months of the study. However, patients in the weight loss group used a significantly fewer number of medication steps than the control group at all time intervals except 3 months. Weight loss appears to be a useful tool in blood pressure management in patients who require medication to control their blood pressure.
authors.affiliation: Center for Excellence in Cardiovascular-Renal Research, Department of Medicine, University of Mississippi Medical Center, Jackson 39216-4505, USA. djones@medicine.umsmed.edu
authors.forename: D W
authors.initials: DW
authors.lastname: Jones
authors.forename: M E
authors.initials: ME
authors.lastname: Miller
authors.forename: M R
authors.initials: MR
authors.lastname: Wofford
authors.forename: D C
authors.initials: DC
authors.lastname: Anderson
authors.forename: M E
authors.initials: ME
authors.lastname: Cameron
authors.forename: D L
authors.initials: DL
authors.lastname: Willoughby
authors.forename: C T
authors.initials: CT
authors.lastname: Adair
authors.forename: N S
authors.initials: NS
authors.lastname: King
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D015992:Body Mass Index; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D004032:Diet; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004656:Enalapril / Q000627:therapeutic use; D015736:Felodipine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use; D008875:Middle Aged; D009765:Obesity / Q000628:therapy; D012307:Risk Factors; D016896:Treatment Outcome; D015431:Weight Loss
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004656:Enalapril; D008790:Metoprolol; D015736:Felodipine