The effects of body weight loss and gain on arterial hypertension control: an observational prospective study

BACKGROUND: Body weight changes are associated with significant variations in blood pressure (BP). Body mass modifications may, therefore, influence hypertension control in primary care. METHODS: Patients with a history of essential arterial hypertension were observed for 12 months. Anthropometric data and clinical BP were evaluated at the time of the recruitment and after 12 months of follow-up. The association between (body mass index) BMI change and BP control was analyzed by logistic regression. RESULTS: Sixteen thousand five hundred and sixty-four patients were recruited, while 13,631 patients (6336 men; 7295 women) finished the 1-year follow-up. In obese patients, a BMI decrease by at least 1 kg/m(2) was negatively associated with uncontrolled hypertension at the end of the follow-up (men p < 0.0001, OR = 0.586, 0.481–0.713, women p < 0.001, OR = 0.732, 0.611–0.876). A similar association was observed in overweight patients (men p < 0.05, OR = 0. 804, 95% CI: 0.636–0.997, women p < 0.05, OR = 0.730, 95% CI: 0.568–0.937). A BMI increase of at least 1 kg/m(2) was associated with a significantly higher odd of uncontrolled hypertension in obese (men p < 0.001, OR = 1.471, 1.087–1.991, women p < 0.001, OR = 1.422, 1.104–1.833) and overweight patients (men p < 0.0001, OR = 1.901, 95% CI: 1.463–2.470, women p < 0.0001, OR = 1.647, 95% CI: 1.304–2.080). CONCLUSIONS: Weight loss is inversely associated and weight increase is positively associated with the probability of uncontrolled hypertension in obese and overweight hypertensives.