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January 1, 2001Hypertension ResearchOpen Access

Differences in Mechanisms between Weight Loss-Sensitive and -Resistant Blood Pressure Reduction in Obese Subjects.

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Why the study?

Does sympathetic nervous system activity or fasting plasma leptin/insulin levels explain resistance to blood pressure reduction during weight loss in obese subjects?

Population

113 young, obese men, comprising 61 untreated hypertensive men (HT) and 52 normotensive men (NT)

Design

Cohort

Follow-up

24 weeks

Authors

KMKazuko MasuoBreast Cancer Network AustraliaHMHiroshi MikamiFukushima Medical UniversityTOToshio OgiharaNihon University

Discussion

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Implication

May flag obese patients unlikely to lower BP via weight loss; hypothesis-generating for sympathetic targeting in resistant hypertension.

Key Points

  • To identify whether sympathetic nervous system activity, leptin, and insulin explain resistance to blood pressure reduction following weight loss in obese individuals.
  • Enrolled 61 young obese untreated hypertensive men and 52 obese normotensive men (N=113) into a 24-week intervention of low-calorie diet and aerobic exercise.
  • Assessed body mass index, blood pressure, plasma norepinephrine, leptin, and insulin at baseline and week 24.
  • Classified successful weight loss and blood pressure reduction as a greater than 10% decrease from baseline in body mass index or mean blood pressure, respectively.
  • Successful blood pressure reduction occurred in 64% of participants who achieved target weight loss, compared to 22% among those who did not.
  • Baseline plasma norepinephrine levels were significantly higher in men who failed to reduce blood pressure despite weight loss compared to those who succeeded, while leptin and insulin levels were similar.
  • Participants with successful blood pressure reduction demonstrated significantly greater absolute and percent decrements in plasma norepinephrine, whereas decrements in leptin and insulin did not differ between groups.

Structured PICO

Does sympathetic nervous system activity or fasting plasma leptin/insulin levels explain resistance to blood pressure reduction during weight loss in obese subjects?

P
Population
113 young, obese men, comprising 61 untreated hypertensive men (HT) and 52 normotensive men (NT)
I
Intervention
Weight loss program consisting of a low caloric diet and aerobic exercise over a 24-week period
O
Outcome
Blood pressure reduction (defined as >10% reduction in mean BP from baseline at week 24)surrogate

Sympathetic overactivity, indicated by higher plasma norepinephrine, may explain resistance to blood pressure reduction despite successful weight loss in obese men.

Cite This Study

Masuo et al. (2001) studied this question.

synapsesocial.com/papers/6a766cc5a0847c3df1ec04bbhttps://doi.org/10.1291/hypres.24.371

Topics

Hypertension management
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Reductions in plasma catecholamines and blood pressure during weight loss in obese subjects1983 · 76 citations
  2. 2Factors That Affect Calorie-Sensitive and Calorie-Insensitive Reduction in Blood Pressure During Short-term Calorie Restriction in Overweight Hypertensive Women1996 · 20 citations
  3. 3The effect of weight loss intervention on antihypertensive medication requirements in the hypertension optimal treatment (HOT) study1999 · 89 citations
  4. 4Sympathetic Activation in Obese Normotensive Subjects1995 · 612 citations
  5. 5Relationship between angiotensinogen, leptin and blood pressure levels in young normotensive men1998 · 141 citations