The effect of weight loss intervention on antihypertensive medication requirements in the hypertension optimal treatment (HOT) study

Jones, Daniel W.; Miller, Margaret E; Wofford, Marion R.; Anderson, Douglas C.; Cameron, Mary; Willoughby, D; Adair, Catherine; King, Nancy

doi:10.1016/s0895-7061(99)00123-5

Cited by 77 publications

(42 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Others could reduce the number and doses of medications. 16 A recent meta-analysis estimated that for every kilogram of weight loss, systolic blood pressure would decrease by 1.05 mm Hg (95% confidence interval: 0.66-1.43) and diastolic blood pressure would decrease by 0.92 mm Hg (95% confidence interval: 0.55-1.28). 17 Although the ultimate responsibility for achieving a healthy weight rests with the patient, the patient's family, clinicians, and others can play major supportive roles.…”

Section: Discussionmentioning

confidence: 99%

Trends in Obesity and Abdominal Obesity Among Hypertensive and Nonhypertensive Adults in the United States

Ford

Zhao

et al. 2008

American Journal of Hypertension

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Trends in Obesity and Abdominal Obesity Among Hypertensive and Nonhypertensive Adults in the United States

Ford

Zhao

et al. 2008

American Journal of Hypertension

View full text Add to dashboard Cite

show abstract

“…17 Persistence of obesity is one of the major reasons for the failure of antihypertensive treatment and for refractory hypertension. 18 Moreover, clinical experience indicates the difficulty in maintaining a long-term weight reduction. 19 Consequently, knowing whether or not genetic background influences changes in body weight, and if this influence is modifiable through antihypertensive treatment, can help in the management of hypertension.…”

Section: Discussionmentioning

confidence: 99%

Body weight changes and the A-6G polymorphism of the angiotensinogen gene

et al. 2002

View full text Add to dashboard Cite

BACKGROUND:The objective of the study was to analyze the relationship of polymorphisms of the angiotensinogen gene with changes in body weight during 3 y of antihypertensive treatment, in a group of young adults with essential hypertension. METHODS: Essential hypertensives, less than 50 y old, never previously treated with antihypertensive drugs and in the absence of diabetes mellitus were included. After the initial evaluation, patients were treated using only non-pharmacological measures (n ¼ 29), b-blockers (n ¼ 40) or angiotensin-converting enzyme inhibitors (n ¼ 66). Resting blood pressure, biochemical profile and body weight at the beginning and yearly were measured. The polymorphism A-6G of the angiotensinogen gene located in the promoter region was analyzed. RESULTS: One-hundred and thirty-five patients were included. Genotypes of the A-6G polymorphism of the AGT gene were in Hardy -Weinberg equilibrium (AA 34, AG 63, GG 38). No significant differences were observed among genotypes in terms of age, body mass index, body weight, systolic or diastolic blood pressure. No significant differences in the genotype distribution or in the allele frequencies were observed, although the A allele was most frequent among the obese subjects. During the 3 y of antihypertensive treatment, there was a trend to increase weight despite the dietary recommendations. The slopes of body weight over time, adjusted by age and baseline BMI, differed significantly among the homozygote genotypes (P ¼ 0.006). The highest were for those with the AA genotype and the lowest for the GG genotype (1.180 AE 0.25 and 7 0.128 AE 0.24 kg=y; P ¼ 0.0001). The influence of the genotype in the changes on body weight remained significant after considering its interaction with the kind of antihypertensive treatment, although among subjects carrying the AA genotype those treated with ACEi showed the least body weight change. Furthermore, A-6G genotypes had the largest influence on weight changes, accounting for 19% of the variance, when age, sex and initial body mass index were included in the model. CONCLUSIONS: In a group of young adult hypertensive subjects, there was a trend to increase weight despite dietary recommendations. Subjects with the AA genotype were those with the largest weight gain, but this effect was modified by the antihypertensive treatment.

show abstract

“…In three studies, weight loss was assessed only during a 24-to 48-month induction phase. 53,56,57 Weight loss efficacy. Weight loss was usually o5 kg after 2-3 y (mean (7s.d.…”

Section: Dietary/lifestyle Therapymentioning

confidence: 99%

“…Long-term efficacy of weight loss methods JD Douketis et al Long-term efficacy of weight loss methods Six studies had a 'usual care' control group. 47,[51][52][53]56,59,77 No study reported on weight loss and its effects of cardiovascular risks in high-risk groups, unless the study was limited to high-risk subjects. 47,51,52,56,57,77 Pharmacologic therapy In 19 studies that involved 9953 subjects, the mean age and weight of subjects across studies varied from 40 to 58 y and from 87 to 102 kg (Table 2).…”

Section: Dietary/lifestyle Therapymentioning

confidence: 99%

Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice

et al. 2005

View full text Add to dashboard Cite

BACKGROUND: Obesity is a common health problem that requires a long-term care approach. We systematically reviewed long-term (Z2 y) studies investigating dietary/lifestyle, pharmacologic, and surgical weight loss methods to assess (1) weight loss efficacy, defined by absolute weight loss and the proportion of subjects with Z5% weight loss, (2) effects of weight loss on cardiovascular risk factors, and (3) applicability of findings from studies to everyday clinical practice. METHODS: The MEDLINE, HealthSTAR, and the Cochrane Controlled Trials databases were searched for studies investigating the long-term efficacy of weight loss methods in overweight and obese adults. Data were extracted for (i) weight loss after 1 y (pharmacologic studies only), 2 y, 3 y, and 4 y, (ii) proportion of subjects with Z5% weight loss at the end of follow-up, and (iii) changes (end-of follow-up minus baseline values) in blood lipids, fasting blood glucose, and systolic and diastolic blood pressure. RESULTS: Dietary/lifestyle therapy provides o5 kg weight loss after 2-4 y, pharmacologic therapy provides 5-10 kg weight loss after 1-2 y, and surgical therapy provides 25-75 kg weight loss after 2-4 y. Weight loss of Z5% baseline weight is not consistently associated with improvements in cardiovascular risk factors and these benefits appear to be intervention specific and occur mainly in people with concomitant cardiovascular risk factors. Weight loss studies have methodologic limitations that restrict the applicability of findings to unselected obese people assessed in everyday clinical practice. These limitations include an inadequate study duration, large proportions of subjects lost to follow-up, a lack of an appropriate usual care group, and a lack of reporting of outcomes in high-risk subgroups. CONCLUSIONS: Dietary/lifestyle and pharmacologic weight loss interventions provide modest weight loss, and may improve markers of cardiovascular risk factors although these benefits occur mainly in patients with cardiovascular risks. Studies investigating weight loss have methodologic limitations that restrict the applicability of findings to obese patients assessed in clinical practice.

show abstract

The effect of weight loss intervention on antihypertensive medication requirements in the hypertension optimal treatment (HOT) study

Cited by 77 publications

References 14 publications

Trends in Obesity and Abdominal Obesity Among Hypertensive and Nonhypertensive Adults in the United States

Trends in Obesity and Abdominal Obesity Among Hypertensive and Nonhypertensive Adults in the United States

Body weight changes and the A-6G polymorphism of the angiotensinogen gene

Systematic review of long-term weight loss studies in obese adults: clinical significance and applicability to clinical practice

Contact Info

Product

Resources

About