Obesity-related hypertension: Evaluation of the separate effects of energy restriction and weight reduction on hemodynamic and neuroendocrine status

Weinsier, Roland L.; James, D.; Darnell, Betty E.; Dustan, Harriet P.; Birch, Robert; Hunter, Gary R.

doi:10.1016/0002-9343(91)90606-x

Cited by 17 publications

(14 citation statements)

References 31 publications

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“…Although the drugs as a class are not viewed as having an impact on the adipocyte, it is function. [10][11][12][13] The increased renin secretion observed can be produced by a reduction in macula interesting that in some studies in humans, use of ACE inhibitors has been associated with significant densa sodium chloride delivery. Obesity causes marked increase in renal absolute and fractional weight loss.…”

Section: Discussionmentioning

confidence: 99%

“…12 Elevated PRA and aldoogic agents which block the production of angiotensterone were described in obese humans as well, sin II in the treatment of hypertension, the and weight loss is associated with a reduction in contribution of increased RAS activity to the etiolthese hormones. 10,11 Alterations in the activity of ogy of this disorder is less well accepted. Recent PRA and aldosterone were recently confirmed application of molecular markers associated with among persons with central obesity, including both the genes coding the proteins of the RAS have demhypertensives and normotensives.…”

Section: Introductionmentioning

confidence: 99%

“…Although obesity is the weight, BP and the RAS have been infrequent. [9][10][11][12][13] most important single modifiable risk factor for Rochini et al 9 reported increased aldosterone hypertension, little is known about the mechanism linking the two conditions. We initiated a com- approximately balanced between persons above and *P Ͻ 0.000; **P Ͻ 0.05; ***P Ͻ 0.01 between obese and nonbelow the 140/90 hypertension cut-point were obese groups.…”

Section: Introductionmentioning

confidence: 99%

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ACE, angiotensinogen and obesity: a potential pathway leading to hypertension

et al. 1997

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The renin-angiotensin system (RAS) plays a crucial role and angiotensinogen levels, this relationship persisted in the regulation of fluid volume, thereby influencing for ACE in multivariate analyses controlling for BP, blood pressure (BP). Obesity is an important risk factor hypertension status, age, and gender. The for hypertension, however the physiologic basis for this insertion/deletion polymorphism of the ACE gene was relationship has not been clarified. In a population surassociated with variation in the levels of ACE, but inconvey we examined the potential relationship between the sistently with body mass index. Variants of the angio-RAS and obesity. Based on community sampling, 449 tensinogen gene leading to amino acid substitutions at individuals were recruited from metropolitan Kingston, positions 174 and 235 did not influence levels either of Jamaica. Serum angiotensin-converting enzyme (ACE) angiotensinogen or obesity. These data suggest that and circulating angiotensinogen levels were measured obesity may alter the levels of ACE and angiotensinand the associated genes were typed for previously ogen, and provide a potential pathway through which described polymorphisms. Obese individuals (body obesity leads to elevation of BP. mass index Ͼ31) had significantly higher serum ACE

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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ACE, angiotensinogen and obesity: a potential pathway leading to hypertension

et al. 1997

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“…These findings concur with those found on adult patients after dietary restric- Table 4. Outcome measures: Arterial blood pressures (mmHg), and lipid profile (mg/dL) of the intervention and control superobese children (mean k SD) tion and weight loss (24,25). The control children did not have any decrease in blood pressure at 6 months.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of a Clinic‐Based Hypocaloric Dietary Intervention Implemented in a School Setting for Obese Children

et al. 1996

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Feasibility of a clinic-based hypocaloric dietary intervention implemented in a school setting for obese children. Obes Res. 1996;4:419-429. The objective of this study was to examine whether a protein-sparing modified fast diet and a hypocaloric balanced diet are effective in a clinic-based dietary intervention implemented in a school setting highrisk weight loss program for superobese (2 140% of their ideal body weight for height [IBW]) children. A group of children from two suburban public schools in New Orleans, Louisiana were randomized to either dietary-intervention group and control group. Children were followed for 6 months. In the dietary-intervention-group, 12 of 44 superobese children [ages 8.8 to 13.4 years, weight 144% to 212% of IBW] volunteered to participate. In the control group, 7 of 19 superobese children [ages 9.4 to 12.9 years, weight 140% to 195% of IBW] volunteered to participate. During the first 9 weeks, 12 superobese children were placed on a 2520 to 3360 J (600 to 800 Cal) protein-sparing modified fast diet. Subsequently, the diets of all children were increased in a 3-month period 420 J (100 Cal) every 2 weeks until a 5040 J (1200 Cal) per day balanced diet was attained. In both groups, height and weight were obtained at baseline, 10 weeks, and 6 months; and biochemical measurements were performed at baseline and 6 months.At 6 months the 12 superobese children on protein-sparing modified fast diet had a significant Six children were not superobese at 6 months. At 6 months eight of 12 children were active participants and 11 of 12 children were followed. Decrease in blood pressure, as well as, downward trends in serum lipids were observed at 6 months. No clinical complications were observed. A t 6 months, the 7 control superobese children, when compared with baseline had gained weight (2.8 & 3.1 kg, ANOVA p c 0.008); but had no significant change in percentage IBW (-0.3 f 5.9%, ANOVA p = 0.61); and had no changes in growth velocity Z-score (0.1 k 1.3, ANOVA p = 0.83). These children did not have any change in blood pressure and an upward trend in serum lipids were observed at 6 months.Protein-sparing modified fast diet and a hypocaloric balanced diet appear to be effective in a group of superobese-school-age children in a medically supervised clinic-based program implemented in a school setting over a 6-month period. The efforts of committed clinic staffs, school officials, peers, and family involvement were crucial to the success of this intervention program in promoting and maintaining weight loss over a 6-month period. Further research with a specific comparison of the hypocaloric diets with longer follow-up periods in the school setting is necessary. In the meantime, these diets should be used only with close medical supervision.

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“…Details of the study have been published elsewhere (13). Briefly, energy intake was adjusted until body weight varied <l %.…”

Section: Methodsmentioning

confidence: 99%

Serum Leptin Concentrations and Weight Gain in Postobese, Postmenopausal Women

et al. 1998

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NAGY, TIM R., SUSAN L. DAVIES, GARY R. HUNTER, BETTY DARNELL, ROLAND L. WEINSIER. Serum leptin concentrations and weight gain in postobese, postmenopausal women. Obes Res. 1998;6:257-261. Objective: This study was designed to determine if serum leptin concentrations (adjusted for fat mass) after weight loss on a low-calorie diet predict subsequent weight gain. Research Methods and Procedures: Body composition and serum leptin concentrations were determined on 14 moderately obese, postmenopausal, nondiabetic women with a familial predisposition to obesity. Assessments were obtained under tightly controlled metabolic ward conditions of macronutrient intake and weight maintenance both before (obese state) and after a mean weight loss of 12.0 kg to normal body weight (postobese state). Four years later, without intervention, body weight and body composition were reassessed. Results: Weight loss resulted in significant decreases in fat mass (29.7 ± 5.4 vs. 20.3 ± 4.7; kg), body mass index (27.7 ± 1.6 vs. 23.0 ± 1.5; kg/nr'), percent body fat (40.7 ± 4.3 vs. 33.1 ± 5.0), and serum leptin concentrations (31.8 ± 16.0 vs. 11.5 ± 5.4; ng/mL). Serum leptin concentrations were positively correlated (p<0.05) with fat mass in both the obese and postobese states (r=0.67 and r=0.56, respectively). However, residual serum leptin concentrations (adjusted for fat mass) in the obese and postobese states were not related to that relatively low concentrations of leptin predict weight regain after weight loss. However, because the number of subjects in this study was limited, further studies are warranted.

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Obesity-related hypertension: Evaluation of the separate effects of energy restriction and weight reduction on hemodynamic and neuroendocrine status

Abstract: These results demonstrate that weight loss has a blood pressure-lowering effect that is distinct from energy restriction and that is related to changes in blood volume and cardiac output.

Cited by 17 publications

References 31 publications

ACE, angiotensinogen and obesity: a potential pathway leading to hypertension

ACE, angiotensinogen and obesity: a potential pathway leading to hypertension

Feasibility of a Clinic‐Based Hypocaloric Dietary Intervention Implemented in a School Setting for Obese Children

Serum Leptin Concentrations and Weight Gain in Postobese, Postmenopausal Women

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