title: Effect of body weight loss and normalization on blood pressure in overweight non-obese patients with stage 1 hypertension.
abstract: We evaluated the effects of body weight (BW) loss on blood pressure (BP) in overweight non-obese patients with stage 1 hypertension. We enrolled 376 overweight (body mass index (BMI) >or=25 and <30 kg m(-2)) stage 1 hypertensive patients in this prospective 12-month trial. Each patient received tailored, low caloric dietary advice. After 6 months, patients with a BW reduction <5% were excluded. Body weight, BMI, BP, fasting plasma glucose (FPG), fasting plasma insulin (FPI), leptin (pL), renin and aldosterone levels were evaluated at baseline and after 6 and 12 months. In 222 patients who completed the study, a mean weight reduction of 8.1 kg reduced systolic blood pressure (SBP) by 4.2 mm Hg and diastolic blood pressure (DBP) by 3.3 mm Hg (P<0.05), which was accompanied by a significant decrease in FPI, pL and aldosterone levels (P<0.05). Larger SBP/DBP reductions were observed in 106 patients with normalized BMI (-5/-4.5 mm Hg, P<0.01) compared with the 116 patients who did not become normalized (-3.3/-1.6 mm Hg). The former also presented with greater decreases in FPG, FPI, pL, renin and aldosterone levels. Of the 106 patients who had normalized BMI, 52 also had normalized BP. Clinical and metabolic characteristics of these patients were similar to those of the 56 patients who did not have normalized BP. In overweight, mild hypertensive patients, weight loss was effective in reducing BP and in reversing some endocrinologic alterations associated with being overweight. Half of the patients who had normalized BMI also had normalized BP, which could indicate that these patients essentially did not have a form of hypertension but that these effects were instead secondary to being overweight.
authors.affiliation: Department of Internal Medicine and Therapeutics, Centro Ipertensione e Fisiopatologia Cardiovascolare, University of Pavia, Pavia, Italy. r.fogari@unipv.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Fogari
authors.forename: Annalisa
authors.initials: A
authors.lastname: Zoppi
authors.forename: Luca
authors.initials: L
authors.lastname: Corradi
authors.forename: Paola
authors.initials: P
authors.lastname: Preti
authors.forename: Amedeo
authors.initials: A
authors.lastname: Mugellini
authors.forename: Pierangelo
authors.initials: P
authors.lastname: Lazzari
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Derosa
mesh_terms: D000368:Aged; D000450:Aldosterone / Q000097:blood; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D015992:Body Mass Index; D004038:Diet, Reducing; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology / Q000503:physiopathology*; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications / Q000178:diet therapy* / Q000503:physiopathology*; D011446:Prospective Studies; D012083:Renin / Q000097:blood; D015431:Weight Loss / Q000502:physiology*
chemical_list: D001786:Blood Glucose; D007328:Insulin; D020738:Leptin; D000450:Aldosterone; D012083:Renin