Abstract
The existence of a link between obe-sity and hypertension is nowadays universally ac-cepted; however, there are still some doubts about the fact that weight reduction induces a significant long-term decrease in blood pressure. This clinical trial aimed at evaluating the effects of marked weight loss (at least 30% of excess body weight) induced by a low-energy (600 Kcal), normal sodium diet in severely obese patients, on blood pressure at rest and during sympathetic stimulation. Eight of the 20 patients initially recruited for the study were able to reach the therapeutical goal and brought their body weight from 107 ± 6 to 91 ±4 kg. Their blood pressure (BP) at rest was at the same time reduced from 137/81 ± 5/4 to 122/74 ± 4/4 mmHg. Also, blood pressure measured during three different stimuli (cold pressor test, handgrip and mental arithmetic test) was lowered by this nonpharmacological means. These effects are related solely to weight reduction, since no change in salt intake occurred, as demonstrated by measurements of the 24-h sodium excretion test (191 ± 13 vs 185 ± 10 mEq/24 h). In conclusion, these results support the hypothesis that a drastic weight loss, independently of salt restriction, significantly reduces BP at rest and during stimulation of the adrenergic nervous system.
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References
Havlik R.J., Hubert H.B., Fabsitz R.R., Feinleib M. Weight and hypertension. Ann. Intern. Med. 98:855, 1983.
Langford H.G. Nonpharmacological therapy of hypertension. Commentary on diet and blood pressure. Hypertension 73(Suppl. I): 198, 1989.
Dustan HP. Mechanism of hypertension associated with obesity Ann. Intern. Med. 98:860, 1983.
Mark A.L. Regulation of sympathetic nerve activity in mild human hypertension. J. Hypertens. 8(Suppl. 7): S67, 1990.
Ferrannini E., Happner S.M., Stern MP. Essential hypertension: an insulin-resistant state. J. Cardiovasc. Pharmacol. 75(Suppl. 5): S18, 1990.
Reisin E., Frohlich E.D., Messerli F.H., Dreslinski G.R., Dunn F.G., Jones M.M., Batson H.M. Cardiovascular changes after weight reduction in obesity hypertension. Ann. Intern. Med. 98:315, 1983.
Fagerberg B., Andersson O.K., Isaksson B., Bjorntorp P. Blood pressure control during weight reduction in obese hypertensive men: separate effects of sodium and energy restriction. Br. Med. J. 288:11, 1984.
Reisin E., Abel R., Modan M., Silverberg D.S., Eliahou H.E., Modan B. Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients. N. Engl. J. Med. 298: 1, 1978.
Tuck M.L., Sowers J., Dornfeld L, Kledzik G., Maxwell M. The effect of weight reduction on blood pressure, plasma renin activity, and plasma aldosterone levels in obese patients. N. Engl. J. Med. 304:930, 1981.
Landsberg L, Young J.B. Fasting, feeding and regulation of the sympathetic nervous system. N. Engl. J. Med. 298:1295, 1978.
Grossman E., Eshkol A., Rosenthal T. Diet and weight loss: their effect on norepinephrine renin and aldosterone levels. Int. J. Obesity 9:107, 1985.
Berchtold P., Jorgens V., Kemmer F.W., Berger M. Obesity and hypertension: cardiovascular response to weight reduction. Hypertension 4(Suppl. III): 50, 1982.
Jung R.T., Shetty P.S., Barrand M., Callingham B.A., James W.P.T. Role of catecholamine in hypotensive response to dieting. Br. Med. J. 7; 12, 1979.
Del Rio G., Marrama P., Fiorani P., Delia Casa L. Very low calorie diet induces opposite effects on sympathetic nervous system and adrenomedullary responses. Int. J. Obesity 73(Suppl. 2): 173, 1989.
Andersson O.K., Fagerberg B., Hedner T. Importance of dietary salt in the hemodynamic adjustment to weight reduction in obese hypertensive men. Hypertension 6:814, 1984.
Sims E.A.H. Mechanisms of hypertension in the overweight. Hypertension 4 (Suppl. 3): 43, 1982.
Sowers J.R., Whitfield L.A., Catania R.A., Stern N., Tuck M.L., Dornfeld L, Maxwell M. Role of the sympathetic nervous system in blood pressure maintenance in obesity. J. Clin. Endocrinol. Metab. 54:1181, 1982.
Pentel P.R., Eisen T. Effects of phenylpropanolamine and isometric exercise on blood pressure. Int. J. Obesity 72:199, 1988.
Victor R.G., Leimbach W.N., Seals D.R., Wallin B.G., Mark A.L. Effects of the cold pressor test on muscle sympathetic nerve activity in humans. Hypertension 9:429, 1987.
Ferrannini E., Buzzigoli G., Bonadonna R., Giorico MA, Oleggini M., Graziadei L, Pedrinelli R., Brandi L, Bevilacqua S. Insulin resistance in essential hypertension. N. Engl. J. Med. 317:350, 1987.
Fuhm M.T., Shieh S.M., Wu D.A., Chen Y.D.I., Reaven G.M. Abnormalities of carbohydrate and lipid metabolism in patients with hypertension. Arch. Intern. Med. 147:1035, 1987.
Rocchini A.P., Katch V., Kveselis D., Moorehead C., Martin M., Lampman R., Gregory M. Insulin and renal sodium retention in obese adolescents. Hypertension 74:367, 1989.
MacMahon S.W., MacDonald G.J., Bernstein L, Andrews G., Blachet R.B. Comparison of weight reduction with metoprolol in treatment of hypertension in young overweight patients. Lancet 7:1233, 1985.
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De Simone, G., Mancini, M., Mainenti, G. et al. Weight reduction lowers blood pressure independently of salt restriction. J Endocrinol Invest 15, 339–343 (1992). https://doi.org/10.1007/BF03348747
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DOI: https://doi.org/10.1007/BF03348747