Long-Term Weight Loss From Lifestyle Intervention Benefits Blood Pressure?: A Systematic Review
Abstract
Weight gain may increase blood pressure. Weight loss may reduce this. Reviews have considered the long-term effects of weight loss but are related mainly to more obese participants often on obesity medication and/or undergoing obesity surgery. This systematic review, based on lifestyle interventions for adults (18 to 65 years) with mean baseline BMI of <35 kg/m 2 , links weight change to blood pressure difference. A systematic review of studies reporting weight differences and blood pressure outcomes, published between 1990 and 2008 with follow-up of ≥2 years identified 8 clinical trials or controlled before and after studies (represented by 9 articles) and 8 cohort studies. Differences ranged from −11 to +4kg for weight, −7 to +2.2 mm Hg for diastolic blood pressure and −13 to +6.1 mm Hg for systolic blood pressure. For this population group, no quantifiable relationship between weight and diastolic blood pressure difference was found, possibly because of small weight losses, differing weight status responses, or because pharmacologically controlled hypertension masked weight loss influences. Systolic differences were in line with previous reviews of 1 kg:1 mm Hg relationship, but only for follow-up periods of 2 to 3 years, possibly reflecting the fact that regardless of maintained weight loss, blood pressure often reverts back to higher levels. Lifestyle interventions for weight and blood pressure are limited in this target group, and there has been no exploration of successful intervention components. An individual patient data analysis may uncover baseline and medication effects, explore differences between weight groups, and may identify successful components. Such an analysis would enable effective development of preventative interventions for both hypertension and obesity.
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Systematic reviews consistently report a decrease in SBP of about 1 mm Hg per kg of weight loss with follow-up of 2 to 3 years.
“Systematic reviews consistently report a decrease in SBP of about 1 mm Hg per kg of weight loss with follow-up of 2 to 3 years.[111][112][113][114]”
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“A systematic review evaluated the relationship between weight change and BP difference in adults.([36]) The relationship found between weight and SBP difference was 1kg:1mmHg.”
Long-term changes in body weight are associated with changes in blood pressure levels
Markus, M. R. P., Ittermann, T., Baumeister, S., Troitzsch, P., Schipf, S., Lorbeer, R., Aumannn, N., Wallaschofski, H., Dörr, M., Rettig, R., et al. (2014) · Nutrition Metabolism and Cardiovascular Diseases · doi:10.1016/j.numecd.2014.10.011 · Cited by 16 · see citing works
Beaulac, J., & Sandre, D. (2016) · Perspectives in Public Health · doi:10.1177/1757913916653425 · Cited by 15 · see citing works
Jafari, F., Shahriari, M., Sabouhi, F., Khosravi, A., & Eghbali‐Babadi, M. (2016) · PubMed Central · Cited by 15 · see citing works
Seven, E., Husemoen, L. L. N., Wachtell, K., Ibsen, H., Linneberg, A. R., & Jeppesen, J. (2014) · Journal of Hypertension · doi:10.1097/hjh.0000000000000317 · Cited by 15 · see citing works
“A short-term effect of 1mmHg drop per 1 kg weight loss have been reported [27], but reports indicate that the effect diminishes with time and concomitant difficulties in weight loss maintenance results in less-pronounced long-term reductions [28,29].”
BackgroundWeight Loss Therapies and Hypertension Benefits
Katsi, V. K., Manta, E., Fragoulis, C., & Tsioufis, K. P. (2024) · Biomedicines · doi:10.3390/biomedicines12102293 · Cited by 15 · see citing works
“…these two variables is linear, as it has been shown that a 1 kg reduction in body weight through lifestyle interventions can lead to a 1 mmHg reduction in systolic blood pressure levels [19,20 The underlying pathophysiological mechanisms for this association are likely based on adipose tissue.”
BackgroundLong-Term Effectiveness of Non-Drug Recommendations to Treat Hypertension in a Clinical Setting
Riegel, G. R. C., Moreira, L. B., Fuchs, S. C., Gus, M., Nunes, G., Correa, V. A., Wiehe, M., Goncalves, C. C., Fernandes, F. S., & Fuchs, F. D. (2012) · American Journal of Hypertension · doi:10.1038/ajh.2012.103 · Cited by 14 · see citing works
Brissette, C., Jenkins, A. L., Choleva, L., & Vuksan, V. V. V. (2013) · Canadian Journal of Diabetes · doi:10.1016/j.jcjd.2013.08.183 · Cited by 16 · see citing works
Darviri, C., Artemiadis, A., Protogerou, A. D., Soldatos, P., Kranioutou, C., Vasdekis, S. N., Varvogli, L., Nasothimiou, E., Vasilopoulou, E., Karantzi, E., et al. (2015) · Journal of Human Hypertension · doi:10.1038/jhh.2015.99 · Cited by 12 · see citing works
Sympathetic Activation in Resistant Hypertension: Theory and Therapy
Oliva, R., & Bakris, G. L. (2014) · Seminars in Nephrology · doi:10.1016/j.semnephrol.2014.08.009 · Cited by 13 · see citing works
Bishay, R. H., Omari, A., Zang, J., Lih, A., & Kormas, N. (2013) · Clinical Diabetes · doi:10.2337/diaclin.31.1.14 · Cited by 12 · see citing works
Marin‐Couture, É., Moulin, J.-A., Thibault, A.-S., Poirier, P., Després, J., Gallant, A., Lamarre, V., Alméras, N., Lemieux, I., Chabot, C., et al. (2024) · American Journal of Lifestyle Medicine · doi:10.1177/15598276241242013 · Cited by 11 · see citing works
“The current literature demonstrates the bene fi cial relationship between weight loss and BP lowering, 48,49 indicating that a weight loss of ∼ 8 kg is associated with a clinically signi fi cant reduction in both SBP and DBP of 7-10 mm Hg and of 6-7 mm Hg, respectively.”
Weight Loss and Reduction of Blood Pressure and Hypertension
Kuller, L. H. (2009) · Hypertension · doi:10.1161/hypertensionaha.109.138891 · Cited by 10 · see citing works
Partnering with Patients to Improve Therapeutic Outcomes: Incretin-Based Therapy for Type 2 Diabetes
Nadeau, D. A. (2010) · Postgraduate Medicine · doi:10.3810/pgm.2010.05.2137 · Cited by 9 · see citing works
Sosner, P., Bosquet, L., Herpin, D., Guilbeault, V., Latour, É., Paquette-Tannir, L., Juneau, M., Nigam, A., & Gayda, M. (2016) · Journal of Clinical Hypertension · doi:10.1111/jch.12829 · Cited by 10 · see citing works
“While meta-analysis suggested that, for 1 kg of weight loss, 1 mm Hg reduction should be possible for both SBP/DBP,(19) linkage of weight to BP changes have been far from obvious in reviews focusing on long-term programs.(20) Some heterogeneity between the different studies and less responsive changes were reported in…”
BackgroundLee, E.-W., Kim, H.-S., Yoo, B., Lee, E., & Park, J. H. (2022) · Iranian Journal of Public Health · doi:10.18502/ijph.v51i3.8939 · Cited by 8 · see citing works
“compliance (34-36), the latter of reported to be higher when health literacy and self-efficacy are high (37).”
BackgroundHonda, T., Ishida, Y., Oda, M., Noguchi, K., Chen, S., Sakata, S., Oishi, E., Furuta, Y., Yoshida, D., Hirakawa, Y., et al. (2021) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.59394 · Cited by 8 · see citing works
Ghammam, R., Maatoug, J., Harrabi, I., Fredj, S. B., Zammit, N., Laatikainen, T. K., Vartiainen, E. A., Neupane, D., & Ghannem, H. (2022) · Journal of Human Hypertension · doi:10.1038/s41371-022-00672-2 · Cited by 7 · see citing works
“What is known about topic Health education intervention at the community level was found to be effective in reducing blood pressure in a LMIC.”
BackgroundDiet to Stop Hypertension: Should Fats be Included?
Nestel, P. J., & Mori, T. A. (2024) · Current Hypertension Reports · doi:10.1007/s11906-024-01310-7 · Cited by 7 · see citing works
“Conversely weight loss results in BP reduction although the relationship is not linear and weight regain is common [7, 8].”
BackgroundGepner, Y., Goldstein, N., Shelef, I., Schwarzfuchs, D., Zelicha, H., Meir, A. Y., Tsaban, G., & Grossman, E. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-021-06655-2 · Cited by 9 · see citing works
Clinical Practice Guideline for the Management of Overweight and Obesity in Adults in Saudi Arabia
Alshaikh, A., Al-Jedai, A. H., Alfadda, A. A., Al-Robayan, A. A., Bawahab, A., Abo’ouf, S., Sultan, A., Alhozali, A. M., Bawazeer, M. A., Sheshah, E., et al. (2022) · International Journal of Clinical Medicine · doi:10.4236/ijcm.2022.1312045 · Cited by 7 · see citing works
Evaluation of pharmacy-led weight management service to minimise the risk of cardiovascular disease
Peletidi, A., & Kayyali, R. (2021) · Journal of Pharmaceutical Policy and Practice · doi:10.1186/s40545-021-00338-3 · Cited by 7 · see citing works
Recomendaciones preventivas vasculares. Actualización PAPPS 2024
Orozco‐Beltrán, D., Brotons-Cuixart, C., Banegas, J. R., Gil-Guillén, V. F., Cuenca, A. M. C., Martín-Rioboó, E., Jordá-Baldó, A., Vicuña, J., & Navarro-Pérez, J. (2024) · Atención Primaria · doi:10.1016/j.aprim.2024.103123 · Cited by 7 · see citing works
Ganho de peso na vida adulta: preditor da hipertensão arterial?
Peixoto, M. D. R. G., Cordeiro, M. D. M., Ferreira, V. R., Cardoso, C. K. D. S., & Crispim, P. A. A. (2017) · Cadernos Saúde Coletiva · doi:10.1590/1414-462x201700010023 · Cited by 6 · see citing works
Jafari, F., Shahriari, M., Sabouhi, F., Khosravi, A., & Eghbali‐Babadi, M. (2020) · PubMed Central · doi:10.22122/arya.v16i1.1502 · Cited by 6 · see citing works
Phentermine therapy for obesity does not elevate blood pressure
Hendricks, E. J., & Rothman, R. B. (2011) · Diabetes Obesity and Metabolism · doi:10.1111/j.1463-1326.2011.01435.x · Cited by 6 · see citing works
“Average blood pressures are known to decline when obese patients lose weight without pharmacotherapy [2].”
BackgroundEffects of long- and short-term body mass index changes on incident hypertension are different
Xu, J., Guo, R., Xie, Y., Zheng, J., Wang, Y., Dai, Y., Sun, Z., Xing, L., Zhang, X., Sun, Y., et al. (2020) · Nutrition · doi:10.1016/j.nut.2020.110755 · Cited by 5 · see citing works
Benaiges, D., Bisbe, M., Pedro‐Botet, J., de Vargas‐Machuca, A., Ramón, J. M., Pera, M., Villatoro, M., Fontané, L., Julià, H., Climent, E., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9103193 · Cited by 5 · see citing works
“These results are in line with epidemiological studies that had reported a close relationship between weight loss and blood pressure reduction [23,24].”
ResultJiang, J., Wufuer, M., Simayi, A., Nijiati, M., Fan, M., Zhu, P., Chen, F., Shan, G., Xue, F., Tian, X., et al. (2013) · BMJ Open · doi:10.1136/bmjopen-2012-002279 · Cited by 5 · see citing works
Shrewsbury, V. A., Burrows, T. L., Ho, M. M., Jensen, M. E., Garnett, S. P., Stewart, L., Gow, M. L., Ells, L. J., Chai, L. K., Ashton, L., et al. (2018) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2017-003603 · Cited by 5 · see citing works
Filling the treatment gap in the weight management of overweight and obese patients
Gesundheit, N. (2012) · International Journal of Obesity Supplements · doi:10.1038/ijosup.2012.10 · Cited by 5 · see citing works
DeClercq, V., Defries, D. M., Hunt, R., Taylor, C. G., & Zahradka, P. C. (2011) · Wiley eBooks · doi:10.1002/9780470910016.ch4 · Cited by 5 · see citing works
Kwiringira, A., Migisha, R., Bulage, L., Kwesiga, B., Kadobera, D., Upenytho, G., Mbaka, P., Harris, J. R., Hayes, D., & Ario, A. R. (2024) · BMC Family Practice · doi:10.1186/s12875-024-02444-y · Cited by 4 · see citing works
“In addition, the program included several evidence-based components for improving blood pressure control, such as medication adherence [27], regular blood pressure monitoring [26], and encouraging lifestyle changes such as increased physical activity [28].”
BackgroundThe Effect of Behavioral Changes on the Treatment of Hypertension
Salman, L. A., & Cohen, D. L. (2021) · Current Hypertension Reports · doi:10.1007/s11906-021-01164-3 · Cited by 4 · see citing works
Chen, B., Hong, S., Wang, Y., Hu, Q., & Ma, D. (2024) · Nutrients · doi:10.3390/nu16193284 · Cited by 4 · see citing works
“Aucott et al. concluded in their systematic review that weight loss did not improve hypertension [42], and Gepner et al. found no alteration in blood pressure after an 18-month randomized controlled trial [43].”
BackgroundDelgado‐Floody, P., Navarrete, F. C., Poblete, A. O., & Jerez‐Mayorga, D. (2016) · Nutrición Hospitalaria · doi:10.20960/nh.16 · Cited by 4 · see citing works
Norfazilah, A., Julaina, M., & Nawi, A. M. (2015) · South African Family Practice · doi:10.1080/20786190.2015.1016719 · Cited by 4 · see citing works
Lifestyle behaviors and psychosocial outcomes among cancer survivors
Philip, E. J., Salamanca‐Balen, N., Lewis, B., & Merluzzi, T. V. (2018) · Psycho-Oncology · doi:10.1002/pon.4885 · Cited by 4 · see citing works
Weight loss and blood pressure normalization: the relevance of early interventions in hypertension
Cicero, A. F. G. (2010) · Hypertension Research · doi:10.1038/hr.2009.227 · Cited by 4 · see citing works
“Moreover, this relationship is not clear with respect to diastolic blood pressure”
BackgroundWITHDRAWN: The contemporary impact of body mass index on open aortic aneurysm repair
Bellamkonda, K. S., Scali, S. T., D’Oria, M., Columbo, J. A., Stableford, J. A., Goodney, P. P., Powell, R. J., Suckow, B. D., Jacobs, B. N., Cooper, M. A., et al. (2023) · Journal of Vascular Surgery · doi:10.1016/j.jvs.2023.01.019 · Cited by 4 · see citing works
RetractedBattista, E. M. D., Bracken, R. M., Stephens, J. W., Rice, S., Thomas, M. C., Williams, S. P., Mellalieu, S. D., & the Prosiect Sir Gâr Group (2017) · Nutrition Bulletin · doi:10.1111/nbu.12292 · Cited by 4 · see citing works
Lu, X., Wang, J., Chen, S., Lv, L., & Yu, J.-M. (2025) · International Journal of Hypertension · doi:10.1155/ijhy/1165809 · Cited by 2 · see citing works
Multi-omic modelling of body mass index response to a dietary weight loss intervention
Yeo, E. N., Scadden, A. W., Caterer, Z., Sutton, K. J., Konigsberg, I. R., Cole, J. B., LITKOWSKI, E. M., Pan, Z., Lozupone, C., Ostendorf, D. M., et al. (2026) · Gut Microbes · doi:10.1080/19490976.2026.2696645 · Cited by 2 · see citing works
O’Brien, T., Rose, K. M., Focht, B. C., Kahlout, N. A., Jensen, T., Heareth, K., Nori, U. S., & Daloul, R. (2023) · Pilot and Feasibility Studies · doi:10.1186/s40814-023-01417-9 · Cited by 4 · see citing works
“Therefore, our study may have clinically meaningful results, as previous studies have found that a 3 kg (6.6 pounds) weight loss reduces BP [4, 43].”
ResultInfluentialAchieving control of resistant hypertension: Not just the number of blood pressure medications
Schmidt, K. M., Kelley, W., Tringali, S., & Huang, J. (2019) · World Journal of Hypertension · doi:10.5494/wjh.v9.i1.1 · Cited by 1 · see citing works
- Authors
- Aucott, L., Rothnie, H., McIntyre, L., Thapa, M., Waweru, C., & Gray, D.
- Affiliations
- University of Aberdeen (GB)
- Venue
- Hypertension
- Published
- 2009-10
- Volume
- 54
- Issue
- 4
- Pages
- 756-762
- ISSN
- 0194-911X (ISSN-L)
- 1524-4563
- OpenAlex
- W2115856029
- Cited by
- 124
- References
- 31
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 9 · 2023: 5 · 2022: 7 · 2021: 5 · 2020: 6 · 2019: 5 · 2018: 8 · 2017: 8 · 2016: 9 · 2015: 13 · 2014: 9 · 2013: 7 · 2012: 10
- FWCI
- 5.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Hypertension (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 › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Keywords
- weight loss, lifestyle intervention, blood pressure, obesity, long-term weight change, systolic blood pressure, diastolic blood pressure, weight gain, hypertension prevention, obesity prevention
- MeSH terms
- Adolescent, Adult, Aged, Blood Pressure, Humans, Hypertension, Life Style, Middle Aged, Regression Analysis, Time Factors, Weight Loss, Body Mass Index, Young Adult
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