Effect of low energy diet and weight loss on major risk factors, central obesity and associated disturbances in patients with essential hypertension

Abstract

Obesity, especially central, increases the risk of hypertension, hypertriglyceridaemia and diabetes to a significant extent. To determine whether dietary weight reduction can reduce blood pressure (BP) and other cardiovascular risk factors, 217 hypertensives were randomised to receive either 1600 Kcal/day diet (group A, n = 108) or the usual 2100 Kcal/day diet (group B, n = 109). Sodium intake and physical activity were kept similar in both groups. After 16 weeks of follow-up, patients in group A received significantly less energy leading to a 2.8 kg net reduction in mean weight in association with a significant net decrease in mean SBP and DBP (7.5/6.5 mm Hg) compared with nonsignificant changes in group B. There was a significant net decrease in mean total cholesterol (7.0%), low-density lipoprotein (LDL)-cholesterol (7.9%) and triglycerides (8.0%), with a significant net increase in high-density lipoprotein (HDL)-cholesterol (4.0%) in group A compared with group B. New risk factors such as glucose intolerance (8.0%) and central obesity (waist-hip girth ratio, 0.021) showed a significant net reduction compared with group B. Patients with central obesity and other associated disturbances showed maximal reduction in BP and other cardiovascular risk factors with a significantly greater increase in HDL-cholesterol. Mean doses of drugs were similar at entry to the study as well as after 16 weeks in both groups. It is possible that weight reduction due to a low caloric diet can moderate central obesity and associated disturbances in hypertensive subjects.