Effect of body weight changes on 24-hour blood pressure and left ventricular mass in hypertension: a 4-year follow-up.
BACKGROUND
Few data are available on the long-term effects of weight loss on 24-h blood pressure (BP) and left ventricular mass in overweight hypertensive patients.


METHODS
A total of 181 never-treated overweight hypertensive subjects (body mass index, 25 to 39 kg/m(2), office BP 145/94 +/- 12/7 mm Hg) had 24-h BP monitoring and echocardiography twice, at baseline and after 3.8 +/- 2 years (minimum 1 year). None of the subjects received antihypertensive drugs during the follow-up. Main outcome measures were changes in 24-h BP and in left ventricular mass.


RESULTS
Percent change in body weight had a direct relationship with 24-h BP changes (r = 0.35 and 0.31 for systolic and diastolic BP, respectively; both P <.001). The associations with office BP changes (r = 0.13, P =.10 for systolic BP; r = 0.15, P =.06 for diastolic BP) were significantly weaker (both P <.01, z test). The patients who lost weight during follow-up (n = 106) had a significantly lower increase in 24-h BP (+0.6 +/- 9/ +0.2 +/- 6 v +4.9 +/- 9/ +2.7 +/- 7 mm Hg for systolic/diastolic BP, both P <.01) and in left ventricular mass (-3 +/- 30 g v +9 +/- 32 g, P <.02) than the remaining subjects. In a multiple linear regression, a 10% weight loss independently predicted a 4.3/3.8 mm Hg decrease in 24-h systolic/diastolic BP.


CONCLUSIONS
Long-term weight loss determines a sustained BP reduction during the 24 h and a decrease in left ventricular mass in overweight hypertensive subjects. The relation of weight loss with ambulatory BP changes is closer than that with office BP.
Schillaci
Giuseppe
G
Unit of Internal Medicine, Angiology and Arteriosclerosis, Department of Clinical and Experimental Medicine, University of Perugia, via Brunamonti 51, 06122 Perugia, Italy. skill@unipg.it
Pasqualini
Leonella
L
Vaudo
Gaetano
G
Lupattelli
Graziana
G
Pirro
Matteo
M
Gemelli
Fabio
F
De Sio
Michele
M
Porcellati
Carlo
C
Mannarino
Elmo
E
D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D004038:Diet, Reducing; D004039:Diet, Sodium-Restricted; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015431:Weight Loss / Q000502:physiology*