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THE ROLE OF WEIGHT LOSS IN TREATING HYPERTENSION.

Weight reduction is an accepted nonpharmacologic treatment for hypertension. This reanalysis of data from a randomized trial examined the interaction between weight reduction and drug therapy and sought to determine the degree of weight loss necessary to reduce blood pressure.

The 529 patients received either chlorthalidone, 25 mg/day, atenolol, 50 mg/day, or placebo. Within each group, about half the patients continued their usual diet while the rest were counseled about losing weight. All patients had a diastolic BP of 90 to 100 mm Hg and were at 110 to 160 percent of ideal body weight.

In the group attempting weight loss while taking placebo, a loss of at least 4.5 kg was necessary to lower BP significantly. The decrease in diastolic BP with this degree of weight loss -- 11.6 mm Hg -- was similar to that achieved with either active drug in the absence of substantial weight loss. Weight loss enhanced the effect of both drugs: a minimum loss of 2.25 kg potentiated chlorthalidone, but a loss of 4.5 kg or more was required to potentiate atenolol. The combination of active drug and substantial weight loss lowered BP more effectively than any single therapy.

These results suggest that substantial weight reduction, alone or in combination with drug therapy, is worth pursuing in patients with mild diastolic hypertension.

— ASB

Published in Journal Watch General Medicine January 31, 1992

Citation(s):

Wassertheil Smoller S et al. The trial of antihypertensive interventions and management (TAIM) study: adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension. Arch Intern Med 1992 Jan 152 131-136.

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