Introduction

High blood pressure, or hypertension, is a serious health problem that greatly increases the risk of heart disease and stroke. Many people who have high blood pressure are also overweight, which compounds their health problems. Doctors know that even modest weight loss can help control high blood pressure, but as an article in a recent issue of Annals of Internal Medicine illustrates, even those with access to professional weight loss support have difficulty losing weight and keeping it off.

Weight loss made a difference

Almost 600 overweight, middle-aged men and women, all with mild to moderate high blood pressure, participated in an organized weight control program. Their goal was to lose at least 4.5 kg (10 lb) over a 6-month period, and to maintain the weight loss over the next 3 years. All received individual nutrition counseling at the start of the program, and were then encouraged to attend regularly scheduled classes that offered additional instruction and moral support. Blood pressure was measured at several points during the study.

The group's original weight loss efforts were impressive; they lost an average 4.4 kg (almost 10 lb) during the first 6 months of the program. Blood pressure declined as well, with an average 3.7 mm Hg reduction in systolic pressure (the top number) and an average 2.7 mm Hg reduction in diastolic pressure (the bottom number).

But as participation in the organized program waned, so did weight loss efforts. Eighteen months into the program, average weight loss had shrunk to 2 kg (4.4 lb). At the three-year point, the group was only an average .2 kg (approx. 1/2 lb) lighter than they were at the start of the program. And as participants regained lost weight, their blood pressure measurements rose as well.

Discouraging results

The researchers say that, as expected, the people who lost the most weight had the greatest reductions in blood pressure. But, unfortunately those successful at weight loss were in the minority in this study. Less than one-fifth of study participants were able to lose weight and keep it off for 3 years. About one-third managed to lose weight, but had regained it by the end of the study. Most discouraging, though, is that almost one-half lost no significant weight at all.

Participants' willingness to "stick with the program" seemed to affect their weight loss efforts. They were not required to attend a specific number of weight management sessions, and, as the program progressed, participation in the follow-up sessions began to drop off. But those who lost the most weight, at least in the initial stages of the program, were the ones most willing to commit to regular participation in the follow-up sessions.

Key message

The message of this study--that weight control is a key part of managing high blood pressure--is reflected in current guidelines from the US National Institutes of Health. They outline steps that everyone can take to reduce their risk of high blood pressure:

• Maintain a healthy weight; lose weight if you are overweight
• Be more physically active
• Choose foods low in fat and sodium
• If you drink alcoholic beverages, do so in moderation

Source

Long-term weight loss and changes in blood pressure: results of the Trials of Hypertension Prevention, Phase II
VJ. Stevens, E. Obarzanek, NR. Cook, Annals of Internal Medicine., 2001, vol. 134, pp. 1--11

Links

• How to eat if you have high blood pressure
• Studies Back the Benefits of a 'Heart Healthy' Diet
• Losing Weight the Healthy Way
• To quickly access additional accurate information on this and other nutrition-related topics, visit Tufts University's Nutrition Navigator http://www.navigator.tufts.edu