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Obesity and high blood pressure (BP) often coexist. Weight reduction lowers resting BP but its effect on BP during exercise (a predictor of target organ damage) has not been evaluated. Blood pressure was measured at rest and during cycling, before and after weight reduction induced by gastric restriction. Nineteen subjects (4 male), 41 +/-2 (SEM) years of age and body mass index (BMI) of 43 +/- 0.9 kg/m2, were studied. On each occasion BP was measured at rest, at a steady state of 0 and 25 watts, at peak exercise and 1 min into recovery. Body weight was reduced by 28% +/- 6% and BMI decreased from 43.3 +/- 0.9 to 31.5 +/- 0.7 kg/m2 (P < .01). Both BP and heart rate, at rest and at all exercise intensities, were significantly lower after weight reduction. Resting BP decreased from 133 +/-4/87 +/- 3 mm Hg to 115 +/- 4/77 +/- 2 mm Hg (P < .001), and BP at peak exercise decreased from 181 +/- 8/98 +/- 4 to 162 +/- 6/83 +/- 5 mm Hg (P < .001). The change in resting systolic BP did not correlate with the change in body weight or with the change in heart rate, but it correlated with the baseline systolic BP (R = 0.61; P < .005). It is concluded that marked weight reduction reduces BP at rest and at all exercise intensities. Gastroplasty should be considered as an option in morbidly obese hypertensive patients who are not well controlled with conventional treatment, and who fail to lose or to maintain a reduced weight by calorie restriction alone.

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Exercise capacity in untreated adults with LS is significantly reduced. The limitation for most patients was not ventilatory but resulted either from low cardiac output and/or from dysfunction of the peripheral muscles. However, the relative contribution of each of these elements and/or the role of poor fitness needs further study.

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Background: Thoracic T_2–4 sympathectomy (TS) relieves palmar hyperhidrosis. These same roots innervate the heart and the lung. Thoracoscopic TS minimizes damage to the chest wall so that the effect of sympathectomy itself on these organs can be studied. We attempted to determine whether attenuated sympathetic output affects arm or leg exercise tolerance and lung function in young adults who underwent this operation. Methods: Seven subjects, aged 17–30 years, had lung function tests (water spirometer, Godart, Holland), and leg and arm maximal exercise (CPX, MedGraphics, USA), before and 3–6 months after TS. Results: After TS, resting and exercise heart rate and blood pressure were reduced. Baseline leg and arm peak O₂ uptake, 2.08 (0.6) and 1.44 (0.5) liters/min, respectively, were not different from the post-TS values, 2.06 (0.7) and 1.54 (0.5) liters/min (nonsignificant). Post-TS lung functions were not significantly reduced. Conclusion: Thoracoscopic T_2–4 sympathectomy does not lead to a clinically important fall in lung function and does not compromise arm or leg exercise capacity. Therefore, TS can be done safely in young subjects with palmar hyperhidrosis.