Influence of Weight Reduction on Blood Pressure

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Abstract
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.