Long-term effects of weight-reducing interventions in hypertensive patients: systematic review and meta-analysis.
Weight loss is recommended in all major guidelines for antihypertensive therapy. We searched for randomized controlled trials investigating the effects of weight-reducing diets, pharmacologic substances, and invasive interventions for weight reduction on patient-relevant end points and blood pressure (BP) in patients with essential hypertension. No information on the effects on patient-relevant end points was available. Patients assigned to weight loss diets, orlistat, or sibutramine reduced their body weight more effectively than did patients in the usual care/placebo groups. Reduction of BP was higher in patients treated with weight loss diets (systolic BP [SBP]: weighted mean difference [WMD], -6.3 mm Hg; diastolic BP [DBP]: WMD, -3.4 mm Hg) or orlistat (SBP: WMD, -2.5 mm Hg; DBP: WMD, -2.0 mm Hg). Systolic BP increased with sibutramine treatment (WMD, 3.2 mm Hg). In patients with essential hypertension, therapy with a weight loss diet or orlistat resulted in reductions in body weight and BP. Although sibutramine treatment reduced body weight, it did not lower BP.
Horvath
Karl
K
EBM Review Center, Department of Internal Medicine, Medical University of Graz, Graz, Austria. karl.horvath@meduni-graz.at
Jeitler
Klaus
K
Siering
Ulrich
U
Stich
Anne K
AK
Skipka
Guido
G
Gratzer
Thomas W
TW
Siebenhofer
Andrea
A
D001067:Appetite Depressants / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D003503:Cyclobutanes / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000628:therapy*; D007783:Lactones / Q000627:therapeutic use; D009765:Obesity / Q000150:complications / Q000628:therapy*; D000077403:Orlistat; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects*
D001067:Appetite Depressants; D003503:Cyclobutanes; D007783:Lactones; D000077403:Orlistat; C058254:sibutramine