המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-13 14:00:36 EDT (Reuters Health)
By David Douglas
WESTPORT, CT (Reuters Health) – Weight reduction in combination with pharmacologic treatment appears to be the most effective way of dealing with obesity related hypertension, according to researchers in the US and Japan.
Reporting in the June issue of the American Journal of Hypertension, Dr. Toshio Ogihara of Osaka University Graduate School of Medicine and colleagues observe that weight loss is first-line treatment in obesity related hypertension. However, the mechanisms involved and the relative contribution of antihypertensives in such patients is unclear.
To investigate, the researchers studied five groups of 20 obese hypertensives (37 years to 54 years) who were assigned to treatment with amlodipine alone, enalapril alone, amlodipine and weight reduction, enalapril and weight reduction, or weight reduction alone.
At 6 months, regardless of weight reduction, subjects receiving drugs reached the goal blood pressure of 140/90 mm Hg. However, regardless of pharmacologic intervention, those in the weight-loss groups showed greater reductions from baseline in plasma insulin, leptin, and norepinephrine than those not in these groups.
Furthermore, reduction in these plasma markers "were significantly greater and earlier in combined pharmacologic and weight-loss groups" than in those who received drug treatment alone.
Also in groups who were given the ACE inhibitor enalapril, reductions in plasma norepinephrine, insulin and "especially" leptin were greater than in the other groups.
Commenting on the findings, co-researcher Dr. Kazuko Masuo told Reuters Health that "weight loss has very powerful benefits on blood pressure reduction" in the obese, and is "associated with favorable metabolic improvements." These "are further amplified when combined with pharmacological treatment."
Because of this, as well as pharmacologic treatment, "weight loss should be regarded as an essential component of any treatment program for obesity-related hypertension."
Am J Hypertens 2001;14:530-538.
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