title: Weight loss in overweight adults and the long-term risk of hypertension: the Framingham study.
abstract: BACKGROUND
  Few studies address long-term effects of weight loss on risk of incident hypertension among overweight adults.
  
  
  METHODS
  We evaluated weight loss among 623 overweight (body mass index [calculated as weight in kilograms divided by the square of height in meters] >/=25) middle-aged (aged 30-49 years) and 605 overweight older (aged 50-65 years) adults in Framingham, Mass. Subjects were classified first according to amount of weight lost over 4 years: (1) weight changed by less than 1.8 kg (stable weight), (2) lost 1.8 to less than 3.6 kg, (3) lost 3.6 to less than 6.8 kg, and (4) lost 6.8 kg or more. We also classified weight loss according to whether it was sustained during the next 4 years.
  
  
  RESULTS
  After adjusting for age, sex, education, baseline body mass index, height, activity, smoking, and alcohol intake, weight loss of 6.8 kg or more led to a 21% to 29% reduction in long-term hypertension risk. After adjusting for cancer or cardiovascular disease occurring during follow-up, weight loss of 6.8 kg or more led to a 28% reduction in risk (relative risk [95% confidence interval], 0.72 [0.49-1.05]) for middle-aged adults and a 37% reduction (0.63 [0.42-0.95]) for older adults. Sustained weight loss led to a 22% reduction in hypertension risk (0.78 [0.60-1.03]) among middle-aged and a 26% reduction (0.74 [0.56-0.97]) in older adults. This risk reduction was strengthened by adjustment for prevalent cancer or cardiovascular disease during follow-up.
  
  
  CONCLUSIONS
  A modest weight loss, particularly when sustained, substantially lowers the long-term risk of hypertension in overweight adults.
authors.affiliation: Section of Preventive Medicine and Epidemiology, Boston University School of Medicine, Boston, MA 02118, USA. llmoore@bu.edu
authors.forename: Lynn L
authors.initials: LL
authors.lastname: Moore
authors.forename: Agostino J
authors.initials: AJ
authors.lastname: Visioni
authors.forename: M Mustafa
authors.initials: MM
authors.lastname: Qureshi
authors.forename: M Loring
authors.initials: ML
authors.lastname: Bradlee
authors.forename: R Curtis
authors.initials: RC
authors.lastname: Ellison
authors.forename: Ralph
authors.initials: R
authors.lastname: D'Agostino
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology* / Q000209:etiology; D015994:Incidence; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D009765:Obesity / Q000150:complications; D044343:Overnutrition / Q000150:complications*; D012306:Risk; D013997:Time Factors; D015431:Weight Loss