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Effect of body weight changes on 24-hour blood pressure and left ventricular mass in hypertension: a 4-year follow-up

Few data are available on the long-term effects of weight loss on 24-h blood pressure (BP) and left ventricular mass in overweight hypertensive patients. A total of 181 never-treated overweight hypertensive subjects (body mass index, 25 to 39 kg/m 2, office BP 145/94 ± 12/7 mm Hg) had 24-h BP monito...

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Bibliographic Details
Published in:American journal of hypertension 2003-08, Vol.16 (8), p.634-639
Main Authors: Schillaci, Giuseppe, Pasqualini, Leonella, Vaudo, Gaetano, Lupattelli, Graziana, Pirro, Matteo, Gemelli, Fabio, De Sio, Michele, Porcellati, Carlo, Mannarino, Elmo
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Language:English
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Summary:Few data are available on the long-term effects of weight loss on 24-h blood pressure (BP) and left ventricular mass in overweight hypertensive patients. A total of 181 never-treated overweight hypertensive subjects (body mass index, 25 to 39 kg/m 2, office BP 145/94 ± 12/7 mm Hg) had 24-h BP monitoring and echocardiography twice, at baseline and after 3.8 ± 2 years (minimum 1 year). None of the subjects received antihypertensive drugs during the follow-up. Main outcome measures were changes in 24-h BP and in left ventricular mass. Percent change in body weight had a direct relationship with 24-h BP changes ( r = 0.35 and 0.31 for systolic and diastolic BP, respectively; both P < .001). The associations with office BP changes ( r = 0.13, P = .10 for systolic BP; r = 0.15, P = .06 for diastolic BP) were significantly weaker (both P < .01, z test). The patients who lost weight during follow-up ( n = 106) had a significantly lower increase in 24-h BP (+0.6 ± 9/ +0.2 ± 6 v +4.9 ± 9/ +2.7 ± 7 mm Hg for systolic/diastolic BP, both P < .01) and in left ventricular mass (−3 ± 30 g v +9 ± 32 g, P < .02) than the remaining subjects. In a multiple linear regression, a 10% weight loss independently predicted a 4.3/3.8 mm Hg decrease in 24-h systolic/diastolic BP. Long-term weight loss determines a sustained BP reduction during the 24 h and a decrease in left ventricular mass in overweight hypertensive subjects. The relation of weight loss with ambulatory BP changes is closer than that with office BP.
ISSN:0895-7061
1879-1905
1941-7225
DOI:10.1016/S0895-7061(03)00894-X