Body weight variation and control of cardiovascular risk factors in essential hypertension

Objective. The objective was to assess the impact of weight changes on blood pressure (BP), lipids and glucose goals in a cohort of hypertensive subjects. Design. Prospective follow-up. Setting. Hypertension clinic. Patients. 326 hypertensive nondiabetic subjects, 46% with metabolic syndrome (MS). Interventions. Usual care treatment, which included diet, physical exercise and drugs prescribed when indicated. All patients were observed for up to 1 year. Main outcome measures. BP and low-density lipoprotein-cholesterol (LDL-C) goal were those in ESH/ESC and ATP III recommendations, respectively. The glucose goal was to delay progression to type 2 diabetes mellitus, or to achieve blood glucose <100 mg/dl for non-diabetics. According to body weight changes, patients were categorized using adjusted ROC curves models. Results. Overall, there was a significant weight increment of 0.5 kg (95% CI 0.1-0.9 kg); 28 patients (8.6%) lost more than 5 kg, and only four (1.2%) lost more than 10 kg. BP, LDL-C and glucose goals were achieved in 56%, 78% and 61% of patients, respectively. To lose or not gain weight was an independent prognostic factor to achieve the BP goal in all the patients and the LDL goal in the presence of MS. For glucose control, being treated with beta-blockers and/or diuretics was a negative factor. Conclusions. In hypertensive subjects, even small changes in weight may have an important impact on achieving cardiovascular goals, mainly in those with MS.