Factors predicting influence of body weight loss on blood pressure reduction in mild to borderline hypertensives

Abstract

Background to investigate how changes in body weight (BW) af fect office and ambulatory blood pressure (BP) and are related to baseline catecholamines in hypertensives with positive (FH+) and negative (FH-) family history of hypertension.
Methods in 744 borderline to mild hypertensives (535 men and 209 women) participating in the HARVEST study 24-h urine catecholamines, office and ambulatory BP (A&D TM2420 or Spacelabs 90207) were measured. Overweight patients were advised to decrease calorie intake. After 3 months ambulatory BP was repeated. Subjects were divided into two groups, according to whether their BW decreased (G1) or not (GZ) and by FH status (G1FH+, n=118; G1FH-, n=203; C=2FH+, n=178; G2FH-, n=245).
Results After 3 months BW decreased by 2,7±0.1 kg in Gl and increased by 1.0±0.1 kg in G2. Within the two groups, FH+ and FH- subjects changed BW to a similar extent. Office BP fell to a similar extent in the two groups, while ambulatory BP showed a decrease only in Gl in comparison with G2 (systolic BP (SBP)=-1.8±0.5 vs +0.3±0.4 mmHg, p=0.003; diastolic BP (DBP)=-1.7±0.4 vs 0.00.3 mmHg, p=0.001). G1FH+ subjects showed a greater response of 24-h BP fo BW loss than G1FH- (DBP=-2.5±0.5 vs O.6±0.6 mmHg, p=0.04; SBP=2.5±0.7 vs -0.8±0.8 mmHg, ns). In comparison with G2, only G1FH+ subjects showed a significant decrease in ambulatory SBP (p=0.03) and DBP (p=0.01). A negative correlation was observed between baseline urinary Dopamine and changes in 24-h BP in FH+ subjects (SBP r=-0.135, p=0.02; DBP r=-0.119, p=0.047) but not in FH- subjects. In either group no correlation was found between BP changes and Epinephrine or Norepinephrine.
Conclusions in mild hypertensives weight reduction is effective mostiy in patients with FH+. Detection of low Dopamine values is an additional reason for recommending BW loss in these subjects.