Hypertension

Even modest weight loss reduces future hypertension risk

Susan Jeffrey

June 23, 2005

June 23, 2005

Chicago, IL - A new analysis from the Framingham Study suggests that, as has previously been shown in this database for type 2 diabetes, even modest amounts of weight loss can substantially reduce the risk of hypertension over time [ 1 ].

"It was interesting to me that the results were very similar to what we found with diabetes—that is, a very modest amount of weight loss led to a 25% to 35% reduction in the long-term risk of developing high blood pressure, for both middle-aged and older adults," Dr Lynn L Moore (Boston University School of Medicine, MA) told renalwire .

"We once again found that the effect was strongest in people who sustained their weight loss at least over some period of years—in this case, we required them to keep it off for at least four years—but there was a trend toward a benefit even for people who did regain the weight that they had initially lost," she added.

The report appears in the June 13, 2005 issue of the Archives of Internal Medicine.


The weight of evidence. . .

Excess body weight is the strongest risk factor for hypertension, the researchers write. Previous analyses from Framingham have shown a linear change in blood pressure associated with changes in body weight, as well as a reduced risk of diabetes [ 2 ], they note. "That got us thinking about whether there might be a similar effect for hypertension risk, since hypertension and diabetes are two diseases that are very closely linked," Moore said. The aim of this study was to look at the effect of both the amount of weight lost and the persistence of the weight loss on risk of incident hypertension.

Weight loss was evaluated in two groups of overweight adults, 623 participants aged 30 to 49 years and 605 aged 50 to 65 years. Overweight was defined as a body mass index (BMI) >25. The groups were classified according to the amount of weight lost over four years (weight change <1.8 kg [considered stable weight]; lost 1.8 to <3.6 kg; lost 3.6 to <6.8 kg; lost >6.8 kg) and by whether or not the loss was sustained over the next four years.

After adjustment for a variety of factors, including age, sex, baseline BMI, and alcohol intake, weight loss of 6.8 kg or more was associated with a 21% to 29% reduction in long-term risk of hypertension, the researchers report. After further adjustment for cancer and cardiovascular disease occurring during follow-up, the risk reduction was even stronger for both middle-aged and older adults.

Relative risk reduction for incident hypertension associated with weight loss of >6.8 kg: The Framingham Study


Cohort
Risk reduction (%)
Relative risk
95% CI
Age 30-49
28
0.72
0.49-1.05
Age 50-65
37
0.63
0.42-0.95

 

Sustained weight loss of 1.8 kg or more over four years also substantially reduced hypertension risk compared with those who maintained a stable weight.

Relative risk reduction for incident hypertension associated with sustained weight loss of >1.8 kg: The Framingham Study


Cohort
Risk reduction (%)
Relative risk
95% CI
Age 30-49
22
0.78
0.60-1.03
Age 50-65
26
0.74
0.56-0.97

 

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This reduction in risk was strengthened after adjusting for cancer and cardiovascular disease occurring during follow-up, they added.

What seems clear from this and other studies is that it doesn't require a dramatic change in weight to produce some of the beneficial effects of weight loss, Moore said. "You don't have to lose 50 lbs in order to benefit from losing some extra weight," she told renalwire , although clearly, the more overweight someone is, the greater the benefit from greater losses.

She speculated that those who lose these modest amounts of weight might have made some subtle lifestyle changes that tip the energy balance toward weight loss, reaping the benefits of less hypertension and diabetes. "If you add some garden work and walking and don't change your dietary intake, you might shift that energy balance in way that is beneficial and leads to . . . a modest but gradual and continual weight loss," she said.




Sources

  1. Moore LL, Visioni AJ, Qureshi M, et al. Weight loss in overweight adults and the long-term risk of hypertension: The Framingham Study. Arch Intern Med 2005; 165:1298-1303.

  2. Moore LL, Visioni AJ, Wilson P, et al. Can sustained weight loss in overweight individuals reduce the risk of diabetes mellitus? Epidemiology 2000; 11:269-273.

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