Healthnotes Newswire (January 11, 2001)—Reducing body weight by as little as ten pounds can lead to a significant reduction in blood pressure, according to a clinical trial published this month in the Archives of Internal Medicine.¹

In this trial, all subjects had moderately elevated blood pressure (the diastolic, or bottom number, was between 83 and 89) and weighed between 10% and 65% more than their ideal body weight. Some of the participants received intensive counseling on diet aimed at reducing calories by cutting intake of fat, sugar, and alcohol. This group also was encouraged to walk briskly for 30 to 45 minutes four or five times per week. The other subjects received no diet or lifestyle counseling.

During the three-year trial, the subjects who lost the most weight (an average of 10 pounds) experienced a reduction in diastolic blood pressure of 7 points—enough, on average, to reduce blood pressure to normal levels. For every two pounds lost, there was an average reduction in diastolic blood pressure of 1.4 points.

Not unexpectedly, the majority of counseled patients had difficulty maintaining weight loss over the three-year period. On average, patients receiving dietary counseling lost ten pounds in the first six months, but had gained back all but half a pound by the end of trial. Patients who regained the lost weight showed an increase in blood pressure back to initial levels.

About one quarter of adult Americans have high blood pressure, with only 27% of these patients controlling their condition with medication.² Patients with high blood pressure (defined as a blood pressure greater than 140/90) are at greater risk of cardiovascular disease and stroke. Even patients with more modest blood pressure elevation (blood pressure greater than 120/80) appear to have increased health risks.³

These results present good news and bad news for doctors and patients alike. The good news is that even modest weight loss, brought about through small dietary changes and light exercise, can lead to a clinically significant reduction in blood pressure. This reduction in blood pressure is likely to reduce the risk of death from cardiovascular disease and stroke.

The bad news, however, is that dietary and lifestyle counseling appears to be ineffective in the long term for most people. Only one of five subjects in the trial was able to maintain the initial weight loss through the three years of the trial period. The reward for that successful dieter was a large enough drop in blood pressure to help prevent premature death from stroke and heart disease. These results imply that doctors and patients need to devise better strategies for long-term management of obesity and its associated health risks.