Role of weight loss and polyunsaturated fatty acids in improving metabolic fitness in moderately obese, moderately hypertensive subjects.
OBJECTIVE
While the exact regulatory interactions between blood pressure (BP) and obesity are not completely understood, weight loss provides an alternative to pharmacological treatment of hypertension. The intent of this repeated measures study of mild-moderate hypertensive, moderately obese subjects (34 females/18 males) was to determine if the reduction in BP following weight loss could be further affected by modifying the fatty acid (FA) composition of the hypocaloric diet.


METHODS
BP, insulin sensitivity (Si), and lipid parameters were assessed before and after a 10-week calorie-restricted period. Subjects were randomized to one of three dietary groups differing in FA composition. Reduced body weight was maintained for a further 4 weeks and body composition assessment, BP and heart rate measurements were repeated.


RESULTS
Weight loss (10%) in obese hypertensive subjects resulted in substantial improvements in BP, Si and lipid profile. There was no additional effect on the reduction in BP by the type of FA consumed in the diet. Following weight loss, there was a trend for omega-3 FAs to have a protective effect on fat-free mass loss (compared to omega-6 FA Group and saturated FA Group) and a trend to further enhance Si. There were significant improvements in circulating lipid profiles independent of the dietary FA intervention following the weight loss. The improvements in BP and body composition were maintained during the weight-loss maintenance period. The type of fat consumed had minor differential effects on some of the measured metabolic outcomes.


CONCLUSIONS
These results provide strong support for modest weight loss as a treatment for hypertension.
Kriketos
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AD
Center for Human Nutrition, University of Colorado Health Sciences Center, Denver, Colorado 80262, USA.
Robertson
R M
RM
Sharp
T A
TA
Drougas
H
H
Reed
G W
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Storlien
L H
LH
Hill
J O
JO
D000450:Aldosterone / Q000097:blood; D001794:Blood Pressure / Q000187:drug effects; D001823:Body Composition / Q000187:drug effects; D004041:Dietary Fats / Q000494:pharmacology*; D005227:Fatty Acids / Q000494:pharmacology; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology; D043371:Fatty Acids, Omega-6; D005231:Fatty Acids, Unsaturated / Q000494:pharmacology*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000209:etiology* / Q000503:physiopathology; D007328:Insulin / Q000502:physiology; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications* / Q000378:metabolism* / Q000473:pathology; D012083:Renin / Q000097:blood; D015431:Weight Loss / Q000187:drug effects
D004041:Dietary Fats; D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D005231:Fatty Acids, Unsaturated; D007328:Insulin; D008055:Lipids; D000450:Aldosterone; D012083:Renin