Hypertension, Vol 4, 686-691, Copyright © 1982 by American Heart Association
JR Sowers, M Nyby, N Stern, F Beck, S Baron, R Catania and N Vlachis
This study examines factors modulating blood pressure reduction in obese
patients undergoing weight reduction on a low calorie protein diet. Plasma
norepinephrine (NE) was correlated (r = 0.65, p less than 0.01) with blood
pressure in 20 obese patients prior to weight loss. Reductions in blood
pressure levels following upright posture and isometric handgrip exercise
were related to reduction in NE levels after these maneuvers. While plasma
epinephrine levels declined in parallel with NE levels, plasma dopamine
actually increased (p less than 0.05) during the first 2 weeks of caloric
restriction. Prior to weight loss the obese patients demonstrated a
significant rise in prolactin levels following posture and exercise, but
following caloric restriction this was not observed. Levels of plasma renin
activity (PRA) and aldosterone obtained after posture and exercise
maneuvers were reduced after 8 weeks of caloric restriction, and reductions
in PRA were related to reductions in NE (r = 0.56, p less than 0.01).
Reductions in blood pressure in association with caloric restriction in
these obese patients seems to result, in part, from reduced sympathetic
nervous system activity as well as secondary effects of reduced adrenergic
activity on renal sodium excretion and the renin-angiotensin- aldosterone
axis.
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