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

The DOI matches its Crossref record; 146 of the 154 references it cites were found in a registry or an index.

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 We also contacted authors of relevant papers about further published and unpublished work.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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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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