Long-term Weight loss and changes in blood pressure : Results of the Trials of Hypertension prevention, phase II

Long-term Weight loss and changes in blood pressure : Results of the Trials of Hypertension prevention, phase II

Weight loss appears to be an effective method for primary prevention of hypertension. However, the long-term effects of weight loss on blood pressure have not been extensively studied. To present detailed results from the weight loss arm of Trials of Hypertension Prevention (TOHP) II. Multicenter, r...

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Published in:Annals of internal medicine Vol. 134; no. 1; pp. 1 - 11
Main Authors: STEVENS, Victor J, OBARZANEK, Eva, MILLSTONE, Marian, RACZYNSKI, James, BREWER, Amy, SINGH, Bali, COHEN, Jerome, COOK, Nancy R, LEE, I-Min, APPEL, Lawrence J, WEST, Delia Smith, MILAS, N. Carole, MATTFELDT-BEMAN, Mildred, BELDEN, Lorna, BRAGG, Charlotte
Format: Journal Article
Language:English
Published: Philadelphia, PA American College of Physicians 02-01-2001
Subjects:
Adult
Arterial hypertension. Arterial hypotension
Behavior Therapy
Biological and medical sciences
Blood and lymphatic vessels
Blood Pressure - physiology
Cardiology. Vascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
Counseling
Diet
Exercise
Female
Follow-Up Studies
Humans
Hypertension - prevention & control
Male
Medical sciences
Middle Aged
Primary Prevention
Regression Analysis
Risk Factors
Social Support
Time Factors
Weight Loss - physiology
Human
Hypertension
Prevention
Prognosis
Weight loss
Cardiovascular disease
Arterial pressure
Long term
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Summary:Weight loss appears to be an effective method for primary prevention of hypertension. However, the long-term effects of weight loss on blood pressure have not been extensively studied. To present detailed results from the weight loss arm of Trials of Hypertension Prevention (TOHP) II. Multicenter, randomized dinical trial testing the efficacy of lifestyle interventions for reducing blood pressure over 3 to 4 years. Participants in TOHP II were randomly assigned to one of four groups. This report focuses only on participants assigned to the weight loss (n = 595) and usual care control (n = 596) groups. Men and women 30 to 54 years of age who had nonmedicated diastolic blood pressure of 83 to 89 mm Hg and systolic blood pressure less than 140 mm Hg and were 110% to 165% of their ideal body weight at baseline. The weight loss intervention included a 3-year program of group meetings and individual counseling focused on dietary change, physical activity, and social support Weight and blood pressure data were collected every 6 months by staff who were blinded to treatment assignment Mean weight change from baseline in the intervention group was -4.4 kg at 6 months, -2.0 kg at 18 months, and -0.2 kg at 36 months. Mean weight change in the control group at the same time points was 0.1, 0.7, and 1.8 kg. Blood pressure was significantly lower in the intervention group than in the control group at 6, 18, and 36 months. The risk ratio for hypertension in the intervention group was 0.58 (95% CI, 0.36 to 0.94) at 6 months, 0.78 (CI, 0.62 to 1.00) at 18 months, and 0.81 (CI, 0.70 to 0.95) at 36 months. In subgroup analyses, intervention participants who lost at least 4.5 kg at 6 months and maintained this weight reduction for the next 30 months had the greatest reduction in blood pressure and a relative risk for hypertension of 0.35 (CI, 0.20 to 0.59). Clinically significant long-term reductions in blood pressure and reduced risk for hypertension can be achieved with even modest weight loss.
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ISSN:0003-4819
1539-3704
DOI:10.7326/0003-4819-134-1-200101020-00007