Effect of body weight changes on 24-hour blood pressure and left ventricular mass in hypertension: A 4-year follow-up

Background: Few data are available on the long-term effects of weight loss on 24-h blood pressure (BP) and left ventricular mass in overweight hypertensive patients. Methods: A total of 181 never-treated overweight hypertensive subjects (body mass index, 25 to 39 kg/m(2) office BP 145/94 +/- 12/7 mm Hg) had 24-h BP monitoring and echocardiography twice, at baseline and after 3.8 +/- 2 years (minimum I year). None of the subjects received antihypertensive drugs during the follow-up. Main outcome measures were changes in 24-h BP and in left ventricular mass. Results: Percent change in body weight had a direct relationship with 24-h BP changes (r = 0.35 and 0.31 for systolic and diastolic BP, respectively; both P < .001). The associations with office BP changes (r = 0.13, P = .10 for systolic BP; r = 0.15, P = .06 for diastolic BP) were significantly weaker (both P < .01, z test). The patients who lost weight during follow-up (n = 106) had a significantly lower increase in 24-h BP (+0.6 +/- 9/ +0.2 +/- 6 v +4.9 +/- 9/ +2.7 +/- 7 mm Hg for systolic/diastolic BP, both P < .01) and in left ventricular mass (- 3 +/- 30 g v +9 +/- 32 g, P < .02) than the remaining subjects. In a multiple linear regression, a 10% weight loss independently predicted a 4.3/3.8 mm Hg decrease in 24-h systolic/diastolic BP. Conclusions: Long-term weight loss determines a sustained BP reduction during the 24 h and a decrease in left ventricular mass in overweight hypertensive subjects. The relation of weight loss with ambulatory BP changes is closer than that with office BP. (C) 2003 American Journal of Hypertension, Ltd.