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Can losing weight lower high blood pressure?

Last Update: August 27, 2014; Next update: 2017.

You can lower your blood pressure by losing a little weight. But it is not clear whether weight loss alone can protect against long-term harm caused by high blood pressure.

High blood pressure (hypertension) means that the blood vessels are under too much pressure. High blood pressure itself does not usually cause noticeable symptoms. But over the long term constant high blood pressure can damage the arteries and organs such as the heart and kidneys. This means that hypertension is an important risk factor for other health problems like heart attack or stroke.

Many people who have hypertension are overweight. They are often advised to lose weight in order to lower their blood pressure. Researchers from the Cochrane Collaboration tested whether there is any scientific evidence to support this advice. They looked for suitable studies that assessed the effects that diets or weight loss medication had on blood pressure.

Research results

The researchers found eight studies with a total of 2,100 participants that looked at the effect various diets had on blood pressure. Most studies lasted a year. Participants lost 4 kilograms (about 9 pounds) on average and by doing this were also able to lower their blood pressure. The systolic value fell by 4.5 mm Hg, the diastolic by 3 mm Hg.

Another four studies with about 2,000 participants looked at how losing weight with the drug orlistat affected blood pressure. Orlistat is the only drug that has been approved for long-term treatment of obesity in Germany. Results show that weight loss using orlistat can also lower blood pressure: Those participants who took the drug lost an average of about 4 kg (8.8 pounds) over a time span of 6 to 48 months. The systolic value fell by 2.5 mmHg, the diastolic by 2 mm Hg.

Orlistat does cause side effects relatively frequently, mostly digestion problems.

Does weight loss prevent complications?

None of the studies looked at whether a reduction in blood pressure also leads to a lower risk of complications. High blood pressure is a risk factor for cardiovascular diseases, but this does not mean that lowering blood pressure automatically prevents complications, so it is not clear whether blood pressure was lowered enough in the studies to protect blood vessels and organs over the long term. Also, the significance of blood pressure on its own is limited, because the risk of cardiovascular diseases depends on other factors too.

Even though it is not yet clear whether weight loss can also affect the consequences of high blood pressure, it makes sense to lose weight in order to lower blood pressure in any case – and it can help to control blood pressure without medication.

Sources

  • Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Benefit assessment of non-drug treatment strategies in patients with hypertension: weight reduction: Final report; Commission no. A05-21A. August 31, 2006. (IQWiG reports; Volume 12). [PubMed: 23101095]
  • Siebenhofer A, Jeitler K, Horvath K, Berghold A, Siering U, Semlitsch T. Long-term effects of weight-reducing drugs in hypertensive patients. Cochrane Database Syst Rev 2013; (3): CD007654. [PubMed: 23543553]
  • Siebenhofer A, Jeitler K, Berghold A, Waltering A, Hemkens LG, Semlitsch T, Pachler C, et al. Long-term effects of weight-reducing diets in hypertensive patients. Cochrane Database Syst Rev 2011; (9): CD008274. [PubMed: 21901719]
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