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Cited by 118Blood Pressure and Hypertension StudiesSodium Intake and HealthDiet and metabolism studies

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Long-term effects of weight-reducing diets in people with hypertension

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Semlitsch, Thomas, Jeitler, Klaus, Berghold, Andrea, Horvath, Karl, Posch, Nicole, Poggenburg, Stephanie, Siebenhofer, Andrea·2016·Cochrane Database of Systematic Reviews
DOI 10.1002/14651858.cd008274.pub3PMC PMC7154764
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Abstract

BACKGROUND: All major guidelines for antihypertensive therapy recommend weight loss. Dietary interventions that aim to reduce body weight might therefore be a useful intervention to reduce blood pressure and adverse cardiovascular events associated with hypertension. OBJECTIVES: Primary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on all-cause mortality, cardiovascular morbidity, and adverse events (including total serious adverse events, withdrawal due to adverse events, and total non-serious adverse events). Secondary objectives To assess the long-term effects of weight-reducing diets in people with hypertension on change from baseline in systolic blood pressure, change from baseline in diastolic blood pressure, and body weight reduction. SEARCH METHODS: For this updated review, the Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to April 2020: the Cochrane Hypertension Specialised Register, CENTRAL (2020, Issue 3), Ovid MEDLINE, Ovid Embase, and ClinicalTrials.gov. We also contacted authors of relevant papers about further published and unpublished work. The searches had no language restrictions. SELECTION CRITERIA: We included randomised controlled trials (RCTs) of at least 24 weeks' duration that compared weight-reducing dietary interventions to no dietary intervention in adults with primary hypertension. DATA COLLECTION AND ANALYSIS: , we used a random-effects model. MAIN RESULTS: This second review update did not reveal any new trials, so the number of included trials remains the same: eight RCTs involving a total of 2100 participants with high blood pressure and a mean age of 45 to 66 years. Mean treatment duration was 6 to 36 months. We judged the risks of bias as unclear or high for all but two trials. No study included mortality as a predefined outcome. One RCT evaluated the effects of dietary weight loss on a combined endpoint consisting of the necessity of reinstating antihypertensive therapy and severe cardiovascular complications. In this RCT, weight-reducing diet lowered the endpoint compared to no diet: hazard ratio 0.70 (95% confidence interval (CI) 0.57 to 0.87). None of the trials evaluated adverse events as designated in our protocol. The certainty of the evidence was low for a blood pressure reduction in participants assigned to weight-loss diets as compared to controls: systolic blood pressure: mean difference (MD) -4.5 mm Hg (95% CI -7.2 to -1.8 mm Hg) (3 studies, 731 participants), and diastolic blood pressure: MD -3.2 mm Hg (95% CI -4.8 to -1.5 mm Hg) (3 studies, 731 participants). We judged the certainty of the evidence to be high for weight reduction in dietary weight loss groups as compared to controls: MD -4.0 kg (95% CI -4.8 to -3.2) (5 trials, 880 participants). Two trials used withdrawal of antihypertensive medication as their primary outcome. Even though we did not consider this a relevant outcome for our review, the results of these RCTs strengthen the finding of a reduction of blood pressure by dietary weight-loss interventions. AUTHORS' CONCLUSIONS: In this second update, the conclusions remain unchanged, as we found no new trials. In people with primary hypertension, weight-loss diets reduced body weight and blood pressure, but the magnitude of the effects are uncertain due to the small number of participants and studies included in the analyses. Whether weight loss reduces mortality and morbidity is unknown. No useful information on adverse effects was reported in the relevant trials.

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  1. Anderssen, 1995, Diet and exercise intervention have favourable effects on blood pressure in mild hypertensives: the Oslo Diet and Exercise Study (ODES), Blood Pressure, 4, 343, 10.3109/08037059509077619 · DOI
  2. Anderssen, 1996, Improved carbohydrate metabolism after physical training and dietary intervention in individuals with the 'atherothrombogenic syndrome'. Oslo Diet and Exercise Study (ODES). A randomized trial, Journal of Internal Medicine, 240, 203, 10.1046/j.1365-2796.1996.22848000.x · DOI · Paper page
  3. Jacobs, 2009, Association of 1-y changes in diet pattern with cardiovascular disease risk factors and adipokines: results from the 1-y randomized Oslo Diet and Exercise Study, The American Journal of Clinical Nutrition, 89, 509, 10.3945/ajcn.2008.26371 · DOI
  4. Torjesen, 1997, Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial, Diabetes Care, 20, 26, 10.2337/diacare.20.1.26 · DOI
  5. Urdal, 1993, The Oslo Diet and Exercise Study (ODES): Design and objectives, Controlled Clinical Trials, 14, 229, 10.1016/0197-2456(93)90005-X · DOI
  6. Anderssen, 1995, Diet and exercise intervention have favourable effects on blood pressure in mild hypertensives: the Oslo Diet and Exercise Study (ODES), Blood Pressure, 4, 343, 10.3109/08037059509077619 · DOI
  7. Anderssen, 1996, Improved carbohydrate metabolism after physical training and dietary intervention in individuals with the 'atherothrombogenic syndrome'. Oslo Diet and Exercise Study (ODES). A randomized trial, Journal of Internal Medicine, 240, 203, 10.1046/j.1365-2796.1996.22848000.x · DOI · Paper page
  8. Jacobs, 2009, Association of 1-y changes in diet pattern with cardiovascular disease risk factors and adipokines: results from the 1-y randomized Oslo Diet and Exercise Study, The American Journal of Clinical Nutrition, 89, 509, 10.3945/ajcn.2008.26371 · DOI
  9. Torjesen, 1997, Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial, Diabetes Care, 20, 26, 10.2337/diacare.20.1.26 · DOI
  10. Urdal, 1993, The Oslo Diet and Exercise Study (ODES): Design and objectives, Controlled Clinical Trials, 14, 229, 10.1016/0197-2456(93)90005-X · DOI
  11. Wassertheil-Smoller, 1994, The trial of antihypertensive interventions and management (TAIM), Nieren- und Hochdruckkrankheiten, 23 (Suppl 1), S22
  12. Wassertheil-Smoller, 1991, The TAIM Study: Sex-race differences in effects of diet and drugs on cardiovascular risk, Cardiovascular Risk Factors, 1, 427
  13. Blaufox, 1992, Renin predicts diastolic blood pressure response to nonpharmacologic and pharmacologic therapy, JAMA, 267, 1221, 10.1001/jama.1992.03480090069029 · DOI
  14. Davis, 1989, Trial of antihypertensive interventions and management. Design, methods, and selected baseline results, Controlled Clinical Trials, 10, 11, 10.1016/0197-2456(89)90016-0 · DOI
  15. Davis, 1992, Effect of antihypertensive therapy on weight loss. The Trial of Antihypertensive Interventions and Management Research Group, Hypertension, 19, 393, 10.1161/01.HYP.19.4.393 · DOI
  16. Davis, 1994, Lack of effectiveness of a low-sodium/high-potassium diet in reducing antihypertensive medication requirements in overweight persons with mild hypertension. TAIM Research Group. Trial of Antihypertensive Interventions and Management, American Journal of Hypertension, 7, 926, 10.1093/ajh/7.10.926 · DOI
  17. Langford, 1991, Effect of drug and diet treatment of mild hypertension on diastolic blood pressure. The TAIM Research Group, Hypertension, 17, 210, 10.1161/01.HYP.17.2.210 · DOI
  18. Oberman, 1990, Pharmacologic and nutritional treatment of mild hypertension: changes in cardiovascular risk status, Annals of Internal Medicine, 112, 89, 10.7326/0003-4819-112-2-89 · DOI
  19. Wassertheil-Smoller, 1994, The trial of antihypertensive interventions and management (TAIM), Nieren- und Hochdruckkrankheiten, 23 (Suppl 1), S22
  20. Wassertheil-Smoller, 1991, The TAIM Study: Sex-race differences in effects of diet and drugs on cardiovascular risk, Cardiovascular Risk Factors, 1, 427
  21. Wassertheil-Smoller, 1992, The Trial of Antihypertensive Interventions and Management (TAIM) Study. Final results with regard to blood pressure, cardiovascular risk, and quality of life, American Journal of Hypertension, 5, 37, 10.1093/ajh/5.1.37 · DOI
  22. Wylie-Rosett, 1993, Trial of antihypertensive intervention and management: greater efficacy with weight reduction than with a sodium-potassium intervention, Journal of the American Dietetic Association, 93, 408, 10.1016/0002-8223(93)92286-7 · DOI
  23. Blaufox, 1992, Renin predicts diastolic blood pressure response to nonpharmacologic and pharmacologic therapy, JAMA, 267, 1221, 10.1001/jama.1992.03480090069029 · DOI
  24. Davis, 1989, Trial of antihypertensive interventions and management. Design, methods, and selected baseline results, Controlled Clinical Trials, 10, 11, 10.1016/0197-2456(89)90016-0 · DOI
  25. Davis, 1993, Reduction in long-term antihypertensive medication requirements. Effects of weight reduction by dietary intervention in overweight persons with mild hypertension, Archives of Internal Medicine, 153, 1773, 10.1001/archinte.1993.00410150051005 · DOI
  26. Davis, 1992, Effect of antihypertensive therapy on weight loss. The Trial of Antihypertensive Interventions and Management Research Group, Hypertension, 19, 393, 10.1161/01.HYP.19.4.393 · DOI
  27. Davis, 1994, Lack of effectiveness of a low-sodium/high-potassium diet in reducing antihypertensive medication requirements in overweight persons with mild hypertension. TAIM Research Group. Trial of Antihypertensive Interventions and Management, American Journal of Hypertension, 7, 926, 10.1093/ajh/7.10.926 · DOI
  28. Langford, 1991, Effect of drug and diet treatment of mild hypertension on diastolic blood pressure. The TAIM Research Group, Hypertension, 17, 210, 10.1161/01.HYP.17.2.210 · DOI
  29. Oberman, 1990, Pharmacologic and nutritional treatment of mild hypertension: changes in cardiovascular risk status, Annals of Internal Medicine, 112, 89, 10.7326/0003-4819-112-2-89 · DOI
  30. Wassertheil-Smoller, 1994, The trial of antihypertensive interventions and management (TAIM), Nieren- und Hochdruckkrankheiten, 23 (Suppl 1), S22
  31. Wassertheil-Smoller, 1992, The Trial of Antihypertensive Interventions and Management (TAIM) study. Adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension, Archives of Internal Medicine, 152, 131, 10.1001/archinte.1992.00400130141018 · DOI
  32. Wassertheil-Smoller, 1991, The TAIM Study: Sex-race differences in effects of diet and drugs on cardiovascular risk, Cardiovascular Risk Factors, 1, 427
  33. Wassertheil-Smoller, 1992, The Trial of Antihypertensive Interventions and Management (TAIM) Study. Final results with regard to blood pressure, cardiovascular risk, and quality of life, American Journal of Hypertension, 5, 37, 10.1093/ajh/5.1.37 · DOI
  34. Wylie-Rosett, 1993, Trial of antihypertensive intervention and management: greater efficacy with weight reduction than with a sodium-potassium intervention, Journal of the American Dietetic Association, 93, 408, 10.1016/0002-8223(93)92286-7 · DOI
  35. Blaufox, 1992, Renin predicts diastolic blood pressure response to nonpharmacologic and pharmacologic therapy, JAMA, 267, 1221, 10.1001/jama.1992.03480090069029 · DOI
  36. Davis, 1989, Trial of antihypertensive interventions and management. Design, methods, and selected baseline results, Controlled Clinical Trials, 10, 11, 10.1016/0197-2456(89)90016-0 · DOI
  37. Davis, 1993, Reduction in long-term antihypertensive medication requirements. Effects of weight reduction by dietary intervention in overweight persons with mild hypertension, Archives of Internal Medicine, 153, 1773, 10.1001/archinte.1993.00410150051005 · DOI
  38. Davis, 1992, Effect of antihypertensive therapy on weight loss. The Trial of Antihypertensive Interventions and Management Research Group, Hypertension, 19, 393, 10.1161/01.HYP.19.4.393 · DOI
  39. Davis, 1994, Lack of effectiveness of a low-sodium/high-potassium diet in reducing antihypertensive medication requirements in overweight persons with mild hypertension. TAIM Research Group. Trial of Antihypertensive Interventions and Management, American Journal of Hypertension, 7, 926, 10.1093/ajh/7.10.926 · DOI
  40. Langford, 1991, Effect of drug and diet treatment of mild hypertension on diastolic blood pressure. The TAIM Research Group, Hypertension, 17, 210, 10.1161/01.HYP.17.2.210 · DOI
  41. Oberman, 1990, Pharmacologic and nutritional treatment of mild hypertension: changes in cardiovascular risk status, Annals of Internal Medicine, 112, 89, 10.7326/0003-4819-112-2-89 · DOI
  42. Wassertheil-Smoller, 1994, The trial of antihypertensive interventions and management (TAIM), Nieren- und Hochdruckkrankheiten, 23 (Suppl 1), S22
  43. Wassertheil-Smoller, 1992, The Trial of Antihypertensive Interventions and Management (TAIM) study. Adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension, Archives of Internal Medicine, 152, 131, 10.1001/archinte.1992.00400130141018 · DOI
  44. Wassertheil-Smoller, 1991, The TAIM Study: Sex-race differences in effects of diet and drugs on cardiovascular risk, Cardiovascular Risk Factors, 1, 427
  45. Wassertheil-Smoller, 1992, The Trial of Antihypertensive Interventions and Management (TAIM) Study. Final results with regard to blood pressure, cardiovascular risk, and quality of life, American Journal of Hypertension, 5, 37, 10.1093/ajh/5.1.37 · DOI
  46. Wylie-Rosett, 1993, Trial of antihypertensive intervention and management: greater efficacy with weight reduction than with a sodium-potassium intervention, Journal of the American Dietetic Association, 93, 408, 10.1016/0002-8223(93)92286-7 · DOI
  47. Blaufox, 1992, Renin predicts diastolic blood pressure response to nonpharmacologic and pharmacologic therapy, JAMA, 267, 1221, 10.1001/jama.1992.03480090069029 · DOI
  48. Davis, 1989, Trial of antihypertensive interventions and management. Design, methods, and selected baseline results, Controlled Clinical Trials, 10, 11, 10.1016/0197-2456(89)90016-0 · DOI
  49. Davis, 1993, Reduction in long-term antihypertensive medication requirements. Effects of weight reduction by dietary intervention in overweight persons with mild hypertension, Archives of Internal Medicine, 153, 1773, 10.1001/archinte.1993.00410150051005 · DOI
  50. Davis, 1992, Effect of antihypertensive therapy on weight loss. The Trial of Antihypertensive Interventions and Management Research Group, Hypertension, 19, 393, 10.1161/01.HYP.19.4.393 · DOI
  51. Davis, 1994, Lack of effectiveness of a low-sodium/high-potassium diet in reducing antihypertensive medication requirements in overweight persons with mild hypertension. TAIM Research Group. Trial of Antihypertensive Interventions and Management, American Journal of Hypertension, 7, 926, 10.1093/ajh/7.10.926 · DOI
  52. Langford, 1991, Effect of drug and diet treatment of mild hypertension on diastolic blood pressure. The TAIM Research Group, Hypertension, 17, 210, 10.1161/01.HYP.17.2.210 · DOI
  53. Oberman, 1990, Pharmacologic and nutritional treatment of mild hypertension: changes in cardiovascular risk status, Annals of Internal Medicine, 112, 89, 10.7326/0003-4819-112-2-89 · DOI
  54. Wassertheil-Smoller, 1994, The trial of antihypertensive interventions and management (TAIM), Nieren- und Hochdruckkrankheiten, 23 (Suppl 1), S22
  55. Wassertheil-Smoller, 1992, The Trial of Antihypertensive Interventions and Management (TAIM) study. Adequate weight loss, alone and combined with drug therapy in the treatment of mild hypertension, Archives of Internal Medicine, 152, 131, 10.1001/archinte.1992.00400130141018 · DOI
  56. Wassertheil-Smoller, 1991, The TAIM Study: Sex-race differences in effects of diet and drugs on cardiovascular risk, Cardiovascular Risk Factors, 1, 427
  57. Wassertheil-Smoller, 1992, The Trial of Antihypertensive Interventions and Management (TAIM) Study. Final results with regard to blood pressure, cardiovascular risk, and quality of life, American Journal of Hypertension, 5, 37, 10.1093/ajh/5.1.37 · DOI
  58. Wylie-Rosett, 1993, Trial of antihypertensive intervention and management: greater efficacy with weight reduction than with a sodium-potassium intervention, Journal of the American Dietetic Association, 93, 408, 10.1016/0002-8223(93)92286-7 · DOI
  59. Bahnson, 1997, Baseline characteristics of randomized participants in the trial of nonpharmacologic intervention in the elderly (TONE), Disease Management & Clinical Outcomes, 1, 61, 10.1016/S1088-3371(97)00005-3 · DOI
  60. Fessler, 1998, Sodium reduction and weight loss instead of treatment with antihypertensive agents. [German], Deutsche Apotheker Zeitung, 138, 36
  61. Hypertension Prevention Collaborative Research Group, 1993, The impact of weight loss on blood pressure, Patient Care, 27, 16
  62. Angelico, 2009, Low-fat, low-calorie, Mediterranean-style diet improves endothelial dysfunction in patients with the metabolic syndrome, Journal of Diabetes, 1, A43
  63. Appel, 2006, The effects of macronutrient intake on blood pressure: Subgroup analyses from the OmniHeart randomized feeding study, Journal of Hypertension, 24, 177
  64. Bao, 1999, Dietary fish and weight reduction improves multiple risk factors in overweight, treated hypertensives. [abstract], Australian & New Zealand Journal of Medicine, 29, 148
  65. Bouchonville, 2012, Weight Loss, Exercise, or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial, Endocrine Reviews, 33, S18, 10.1038/ijo.2013.122 · DOI · Paper page
  66. Cambien, 1986, Comparative study of a medical and a dietary intervention in overweight hypertensive patients, Archives des Maladies du Coeur et des Vaisseaux, 79, 1002
  67. Ebell, 2013, Intensive lifestyle intervention fails to improve patient-oriented outcomes in persons with obesity and diabetes, American Family Physician, 88, 864A
  68. Hayward, 2010, Lifestyle modification and NAFLD: A prospective, randomized trial, Hepatology, 52, 622A
  69. Masuo, 2012, The effects of weight loss on liver function in obese hypertensive patients, Circulation, 125, P131
  70. McCarron, 2000, Cardiovascular risk reduction dietary intervention trial, Drug Benefit Trends, 12, 42
  71. Tate, 2011, Replacing caloric beverages with water or diet beverages for weight loss in adults: Results of a 6-month randomized controlled trial, Obesity, 19, S68
  72. Tunyan, 2007, Cardioprotective effects of antihypertensive therapy with orlistat treatment and hypocaloric diet in combination in obese hypertensive patients, Circulation, 115, e248
  73. Anderssen, 1995, Diet and exercise intervention have favourable effects on blood pressure in mild hypertensives: the Oslo Diet and Exercise Study (ODES), Blood Pressure, 4, 343, 10.3109/08037059509077619 · DOI
  74. Haynes B RE: Cochrane Review [personal communication] Email to: A Siebenhofer.
  75. The Nordic Cochrane Centre, The Cochrane Collaboration Review Manager (RevMan) 2014
  76. Urdal, 1993, The Oslo Diet and Exercise Study (ODES): Design and objectives, Controlled Clinical Trials, 14, 229, 10.1016/0197-2456(93)90005-X · DOI

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Authors
Semlitsch, T., Jeitler, K., Berghold, A., Horvath, K., Posch, N., Poggenburg, S., & Siebenhofer, A.
Affiliations
  • Medical University of Graz (AT)
  • Goethe University Frankfurt (DE)
ORCID
Venue
Cochrane Database of Systematic Reviews
Publisher
Wiley
Published
2016-03-02
Volume
2
Pages
CD008274-CD008274
ISSN
  • 1361-6137 (ISSN-L)
  • 1465-1858
DOI
10.1002/14651858.cd008274.pub3
PMC
PMC7154764
OpenAlex
W2290414732
Cited by
118
References
154
Citations by year
2026: 1 · 2025: 10 · 2024: 10 · 2023: 10 · 2022: 15 · 2021: 18 · 2020: 16 · 2019: 16 · 2018: 10 · 2017: 9 · 2016: 2
FWCI
2.14
Type
journal article
Language
en
Update notices
new_version (2021-02-08)
Open access
Locations
  • Cochrane Database of Systematic Reviews (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
  • Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
  • Health Sciences › Medicine › Physiology (medical) › Diet and metabolism studies
Keywords
hypertension, weight loss diet, dietary weight loss, blood pressure reduction, cardiovascular morbidity, all-cause mortality, adverse events, weight loss, antihypertensive therapy, essential hypertension, long-term effects, cardiovascular complications, antihypertensive withdrawal, risk of bias, quality of evidence
MeSH terms
Aged, Blood Pressure, Cardiovascular Diseases, Diet, Reducing, Humans, Hypertension, Middle Aged, Weight Loss, Randomized Controlled Trials as Topic

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