Effect of Body Weight Loss on Blood Pressure After 6 Years of Follow-Up in Stage 1 Hypertension

Winnicki, Mikołaj; Bonso, Elisa; Dorigatti, Francesca; Longo, Daniele; Zaetta, Vania; Mattarei, M; D’Este, D; Laurini, Giorgio; Pessina, Achille C.; Palatini, Paolo

doi:10.1016/j.amjhyper.2006.04.016

Cited by 28 publications

(15 citation statements)

References 21 publications

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“…Participants were required to stay within 5% of their study entry body weight throughout the study. Weight stability was required because changes in weight and/or BMI are independently associated with changes in blood pressure (Winnicki et al 2006) and aldosterone levels (Engeli et al 2005). It was important to ensure that any changes to blood pressure or aldosterone were independent of weight changes.…”

Section: Dietary Stabilization/medication Taperingmentioning

confidence: 99%

Differential aerobic exercise‐induced changes in plasma aldosterone between African Americans and Caucasians

Jones

Dowling

Park

et al. 2007

Experimental Physiology

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Aldosterone influences the kidney's regulation of blood pressure (BP), but aldosterone can contribute to the pathogenesis of hypertension. Blood pressure is reduced with aerobic exercise training (AEX), but the extent to which plasma aldosterone (PA) levels change is unclear. The purpose of this study was to determine whether 6 months of AEX changed PA levels, 24 h sodium (Na + ) excretion and BP in prehypertensive and hypertensive subjects and whether these changes differed according to ethnicity. The study was performed in the Kinesiology Department at the University of Maryland, College Park, and 35 (22 Caucasian; 13 African American) sedentary prehypertensive and hypertensive subjects completed 6 months of AEX. Blood samples were collected under fasting and supine conditions, and PA was measured by radioimmunoassay. In total population aerobic exercise training increased maximal oxygen consumption (24 ± 0.8 versus 28 ± 1 ml kg −1 min −1 , P < 0.001) and decreased PA levels (97 ± 11 versus 72 ± 6 pg ml −1 , P = 0.01), body mass index (28 ± 0.5 versus 28 ± 0.5 kg m −2 , P = 0.004) and weight (85 ± 2 versus 83 ± 2 kg, P = 0.003). Aerobic exercise training decreased PA levels (from 119 ± 16 to 81 ± 7 pg ml −1 , P = 0.02) in the Caucasians but there was no change in BP or Na + excretion. African American participants had no significant changes in PA levels, BP and Na + excretion. Plasma aldosterone levels were 47% lower at baseline (P = 0.01) and 30% lower after AEX (P = 0.04) in African American participants compared with Caucasians. Baseline (P = 0.08) and final PA levels (P = 0.17) did not differ between the two groups after accounting for baseline and final intra-abdominal fat, respectively. The reduction in PA levels with AEX appeared to be driven by the change in PA levels in Caucasian participants. Fat distribution contributed to the ethnic differences in PA levels.

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Section: Dietary Stabilization/medication Taperingmentioning

confidence: 99%

Differential aerobic exercise‐induced changes in plasma aldosterone between African Americans and Caucasians

Jones

Dowling

Park

et al. 2007

Experimental Physiology

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“…Some clinical studies have indicated that weight loss among overweight and obese subjects can reduce the risk of hypertension. [23][24][25][26] Conversely, Winnicki et al 27 showed that in stage 1 hypertensives followed for more than 6 years, the doseresponse relationship between BW loss and decrease in BP was not linear, irrespective of initial BW. Body weight loss 413% of the initial weight did not elicit an additional BP decrease.…”

Section: Introductionmentioning

confidence: 99%

Effect of body weight loss and normalization on blood pressure in overweight non-obese patients with stage 1 hypertension

et al. 2010

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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) X25 and o30 kg m À2 ) 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 o5% 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 (Po0.05), which was accompanied by a significant decrease in FPI, pL and aldosterone levels (Po0.05). Larger SBP/DBP reductions were observed in 106 patients with normalized BMI (À5/À4.5 mm Hg, Po0.01) compared with the 116 patients who did not become normalized (À3.3/À1.6 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. Keywords: blood pressure; overweight; weight-loss INTRODUCTION Excessive body weight (BW), in particular abdominal obesity, increases the risk for cardiovascular disease, stroke, type 2 diabetes, hypertension, lipoprotein disorders, osteoarthritis, certain types of cancers and total mortality. 1-5 An escalating epidemic of overweight (body mass index (BMI) X25 and o30 kg m À2 ) and obesity (BMI 430 kg m À2 ), is affecting both industrialized and many developing countries in the world, and constitutes a major public health problem. 4,6,7 In particular, in the United States, the prevalence of obesity was estimated at 32% of the population. Being overweight was even more prevalent, representing 42% of men and 28% of women, of whom 34 and 39%, respectively, had high blood pressure (BP). 8,9 The coexistence of hypertension and excessive BW greatly enhances cardiovascular risk. 2,10 Recent recommendations suggest the use of stratification tables to calculate the percentage of increased cardiovascular risk in patients with hypertension and excess BW or obesity. 11 The mechanisms underlying hypertension in subjects with excessive BW

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“…Body mass index was calculated as weight in kilograms divided by the square of height in meters and was rounded to the nearest 10th. Overweight was defined as a BMI of 25.0 to 29.9 kg/m 2 and obesity as a BMI of 30.0 kg/m 2 or higher [19,20].…”

Section: Study Protocolmentioning

confidence: 99%

RGS2 C1114G polymorphism and body weight gain in hypertensive patients

et al. 2008

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Effect of Body Weight Loss on Blood Pressure After 6 Years of Follow-Up in Stage 1 Hypertension

Abstract: Our results indicate that in stage 1 hypertensives followed for more than 6 years the dose-response relationship between BW loss and decrease in BP is not linear irrespective of initial BW. The BW loss >13% of initial weight did not elicit additional BP decrease.

Cited by 28 publications

References 21 publications

Differential aerobic exercise‐induced changes in plasma aldosterone between African Americans and Caucasians

Differential aerobic exercise‐induced changes in plasma aldosterone between African Americans and Caucasians

Effect of body weight loss and normalization on blood pressure in overweight non-obese patients with stage 1 hypertension

RGS2 C1114G polymorphism and body weight gain in hypertensive patients

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