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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.[111][112][113][114]”
From Obesity‐Related Hypertension: Pathogenesis, Cardiovascular Risk, and Treatment: A Position Paper of The Obesity Society and the American Society of Hypertension (2013) · cites this paper as [113]
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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 8
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 8
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 9
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
Jafari, F., Shahriari, M., Sabouhi, F., Khosravi, A., & Eghbali‐Babadi, M. (2020) · PubMed Central · doi:10.22122/arya.v16i1.1502 · Cited by 6
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
“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
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
“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
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
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
DeClercq, V., Defries, D. M., Hunt, R., Taylor, C. G., & Zahradka, P. C. (2011) · Wiley eBooks · doi:10.1002/9780470910016.ch4 · Cited by 5
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
“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
Chen, B., Hong, S., Wang, Y., Hu, Q., & Ma, D. (2024) · Nutrients · doi:10.3390/nu16193284 · Cited by 4
“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
Norfazilah, A., Julaina, M., & Nawi, A. M. (2015) · South African Family Practice · doi:10.1080/20786190.2015.1016719 · Cited by 4
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
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
“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
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 5
Lu, X., Wang, J., Chen, S., Lv, L., & Yu, J.-M. (2025) · International Journal of Hypertension · doi:10.1155/ijhy/1165809 · Cited by 3
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
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
“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
Metadata
- 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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