Hypertension. 2003;42:878-884
Published online before print September 15, 2003, doi: 10.1161/01.HYP.0000094221.86888.AE
Published online before print September 15, 2003, doi: 10.1161/01.HYP.0000094221.86888.AE
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(Hypertension. 2003;42:878.)
© 2003 American Heart Association, Inc.
Scientific Contributions |
Influence of Weight Reduction on Blood Pressure
A Meta-Analysis of Randomized Controlled Trials
From the Division of Human Nutrition, Wageningen University (J.E.N., B.E.S., F.J.K., J.M.G.), Wageningen, and the Julius Center for Health Sciences and Primary Care, Utrecht University (D.E.G.), Utrecht, Netherlands.
Correspondence to Dr Johanna M. Geleijnse, Wageningen University, Division of Human Nutrition, PO Box 8129, 6700 EV Wageningen, The Netherlands. E-mail marianne.geleijnse{at}wur.nl
Increased body weight is a strong risk factor for hypertension. A meta-analysis of randomized controlled trials was performed to estimate the effect of weight reduction on blood pressure overall and in population subgroups. Twenty-five randomized, controlled trials (comprising 34 strata) published between 1966 and 2002 with a total of 4874 participants were included. A random-effects model was used to account for heterogeneity among trials. A net weight reduction of -5.1 kg (95% confidence interval [CI], -6.03 to -4.25) by means of energy restriction, increased physical activity, or both reduced systolic blood pressure by -4.44 mm Hg (95% CI, -5.93 to -2.95) and diastolic blood pressure by -3.57 mm Hg (95% CI, -4.88 to -2.25). Blood pressure reductions were -1.05 mm Hg (95% CI, -1.43 to -0.66) systolic and -0.92 mm Hg (95% CI, -1.28 to -0.55) diastolic when expressed per kilogram of weight loss. As expected, significantly larger blood pressure reductions were observed in populations with an average weight loss >5 kg than in populations with less weight loss, both for systolic (-6.63 mm Hg [95% CI, -8.43 to -4.82] vs -2.70 mm Hg [95% CI, -4.59 to -0.81]) and diastolic (-5.12 mm Hg [95% CI, -6.48 to -3.75] vs -2.01 mm Hg [95% CI, -3.47 to -0.54]) blood pressure. The effect on diastolic blood pressure was significantly larger in populations taking antihypertensive drugs than in untreated populations (-5.31 mm Hg [95% CI, -6.64 to -3.99] vs -2.91 mm Hg [95% CI, -3.66 to -2.16]). This meta-analysis clearly shows that weight loss is important for the prevention and treatment of hypertension.
Key Words: obesity • body weight • blood pressure • hypertension, obesity • meta-analysis • clinical trials
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