The influence of non-pharmacological management of obesity on a diurnal blood pressure profile

Abstract

Background. Obesity is one of the main factors increasing mortality and the incidence of diseases of the cardiovascular system. The base treatment is a non-pharmacological approach: diet and physical training. We see hypertension in obese people more often than in people of normal weight. The aim of this study was to answer the question of whether or not a 3-month comprehensive program of non-pharmacological treatment of obesity affects the circadian blood pressure profile.

Material and methods. The study was performed with 60 obese women aged 20–37 years who had an average body mass index (BMI) of 36 ± 4.9 kg/m2 and who declared their willingness to participate in the treatment of obesity. Qualified researchers proposed participation in the comprehensive, outpatient, non-pharmacological treatment program for obesity. The program included activities with a dietician, physiotherapist and physician. Patients performed blood pressure measurements using 24-hour ambulatory monitoring (ABPM).

Results. After 3 months of treatment, the participants had a significant decrease in BMI and waist circumference. These changes were accompanied by a significant reduction in fasting insulin concentrations and a decrease in the insulin resistance index. Findings also showed a small but significant reduction in systolic blood pressure — circadian, daytime and nighttime — and a reduction in the incidence characteristics of of ‘non-dipper’ pattern. In the study group significant positive correlations were found between the change in fasting insulin concentration and the change in circadian systolic blood pressure.

Conclusion. A non-pharmacological, comprehensive treatment program for obesity through weight reduction and a reduction of insulin resistance improves the profile of circadian systolic blood pressure and leads to the conversion of ‘non-dipper’ pattern to favourable ‘dipper’ pattern.