[PP.29.16] EFFECT OF VERY SHORT-TERM WEIGHT REDUCTION ON BLOOD PRESSURE IN EXTREME OBESE WELL TREATED HYPERTENSIVE PATIENTS

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Abstract

Objective:

Hypertension is a well-known modifiable cardiovascular risk factor. Extreme obesity also enhance cardiovascular risk. Hypertension and obesity are often present together. Our aim was to investigate the effect of very short-time weight loss on blood pressure in extreme obese patients.

Design and method:

In our retrospective investigation, we included extreme obese (BMI >=40 kg/m2), well treated hypertensive patients (<140/90 mmHg), who participated in our one-week long, hospitalized weight reduction program with dietary intervention. At admission and emission, we measured anthropometric parameters, lipid profile, fasting glucose, systolic and diastolic blood pressure (SBP, DBP), heart rate; and we calculated pulse pressure (PP) and mean arterial pressure (MAP). Antihypertensive therapy was not changed during the weight loss course.

Results:

We involved 72 patients all together (46 women, 26 men). Their age was 51.88 ± 12.39 years. Their body weight was 130.36 ± 25.30 kg, and the BMI was 46.96 ± 6.87 kg/m2 at admission. The patient's SBP was 128.53 ± 12.40 mmHg and diastolic blood pressure was 75.36 ± 9.79 mmHg at the beginning. The PP was 53.17 ± 12.51 mmHg, while MAP was 93.08 ± 8.96 mmHg. The heart rate of them was 71.61 ± 10.14 beat/min. The patients were on an average of 675 ± 172.59 kcal/day diet. As an effect of the one week long low calorie diet, the body weight was decreased to 126.56 ± 24.20 kg, the BMI diminished to 45.62 ± 6.68 kg/m2 (p < 0.0001). The SBP decreased to 124.49 ± 12.97 mmHg (-4.04 ± 13.09 mmHg p < 0.0001), and DBP reduced to 73.65 ± 10.33 mmHg (-1.71 ± 10.51 mmHg, NS). PP diminished to 50.83 ± 13.87 mmHg (NS), MAP decreased to 90.60 ± 9.6 mmHg (p < 0.05) accompanied by a slight (-1,48 beat/min) not significant (p < 0.0001) reduction of heart rate.

Conclusions:

In our study a short-term, approx. 3.80 kg (-2.91%) weight reduction was associated with a significant systolic and a not significant diastolic blood pressure reduction. According to literature data - on population level - only a slight (2–3 mmHg) SBP difference may cause 6–9% reduction in stroke mortality and 4–6 % decrease in coronary mortality risk among obese patients. We would like expand our investigation in a future to assess the duration and long term effect of weight loss on blood pressure in extreme obese hypertensive patients.

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