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Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting

BACKGROUND: We investigated daily blood pressure (BP) changes during fasting periods ranging from 4 to 41 (10.0±3.8) days in a cohort of 1610 subjects, including 920 normotensive, 313 hypertensive nonmedicated, and 377 hypertensive medicated individuals. METHODS AND RESULTS: Subjects underwent a mul...

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Autores principales: Grundler, Franziska, Mesnage, Robin, Michalsen, Andreas, Wilhelmi de Toledo, Françoise
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763762/
https://www.ncbi.nlm.nih.gov/pubmed/33222606
http://dx.doi.org/10.1161/JAHA.120.018649
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author Grundler, Franziska
Mesnage, Robin
Michalsen, Andreas
Wilhelmi de Toledo, Françoise
author_facet Grundler, Franziska
Mesnage, Robin
Michalsen, Andreas
Wilhelmi de Toledo, Françoise
author_sort Grundler, Franziska
collection PubMed
description BACKGROUND: We investigated daily blood pressure (BP) changes during fasting periods ranging from 4 to 41 (10.0±3.8) days in a cohort of 1610 subjects, including 920 normotensive, 313 hypertensive nonmedicated, and 377 hypertensive medicated individuals. METHODS AND RESULTS: Subjects underwent a multidisciplinary fasting program with a daily intake of ≈250 kcal. Weight and stress scores decreased during fasting, and the well‐being index increased, documenting a good tolerability. BP mean values decreased from 126.2±18.6/81.4±11.0 to 119.7±15.9/77.6±9.8 mm Hg (mean change, −6.5/3.8 mm Hg). BP changes were larger for hypertensive nonmedicated subjects (>140/90 mm Hg) and reduced by 16.7/8.8 mm Hg. This reduction reached 24.7/13.1 mm Hg for hypertensive nonmedicated subjects (n=76) with the highest BP (>160/100 mm Hg). In the normotensive group, BP decreased moderately by 3.0/1.9 mm Hg. Interestingly, we documented an increase of 6.3/2.2 mm Hg in a subgroup of 69 female subjects with BP <100/60 mm Hg. In the hypertensive medicated group, although BP decreased from 134.6/86.0 to 127.3/81.3 mm Hg, medication was stopped in 23.6% of the subjects, whereas dosage was reduced in 43.5% and remained unchanged in 19.4%. The decrease in BP was larger in subjects fasting longer. Baseline metabolic parameters, such as body mass index and glucose levels, as well as age, can be used to predict the amplitude of the BP decrease during fasting with a machine learning model. CONCLUSIONS: Long‐term fasting tends to decrease BP in subjects with elevated BP values. This effect persisted during the 4 days of stepwise food reintroduction, even when subjects stopped their antihypertensive medication. REGISTRATION: URL: https://www.drks.de/drks_web/; Unique identifier: DRKS00010111.
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spelling pubmed-77637622020-12-28 Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting Grundler, Franziska Mesnage, Robin Michalsen, Andreas Wilhelmi de Toledo, Françoise J Am Heart Assoc Original Research BACKGROUND: We investigated daily blood pressure (BP) changes during fasting periods ranging from 4 to 41 (10.0±3.8) days in a cohort of 1610 subjects, including 920 normotensive, 313 hypertensive nonmedicated, and 377 hypertensive medicated individuals. METHODS AND RESULTS: Subjects underwent a multidisciplinary fasting program with a daily intake of ≈250 kcal. Weight and stress scores decreased during fasting, and the well‐being index increased, documenting a good tolerability. BP mean values decreased from 126.2±18.6/81.4±11.0 to 119.7±15.9/77.6±9.8 mm Hg (mean change, −6.5/3.8 mm Hg). BP changes were larger for hypertensive nonmedicated subjects (>140/90 mm Hg) and reduced by 16.7/8.8 mm Hg. This reduction reached 24.7/13.1 mm Hg for hypertensive nonmedicated subjects (n=76) with the highest BP (>160/100 mm Hg). In the normotensive group, BP decreased moderately by 3.0/1.9 mm Hg. Interestingly, we documented an increase of 6.3/2.2 mm Hg in a subgroup of 69 female subjects with BP <100/60 mm Hg. In the hypertensive medicated group, although BP decreased from 134.6/86.0 to 127.3/81.3 mm Hg, medication was stopped in 23.6% of the subjects, whereas dosage was reduced in 43.5% and remained unchanged in 19.4%. The decrease in BP was larger in subjects fasting longer. Baseline metabolic parameters, such as body mass index and glucose levels, as well as age, can be used to predict the amplitude of the BP decrease during fasting with a machine learning model. CONCLUSIONS: Long‐term fasting tends to decrease BP in subjects with elevated BP values. This effect persisted during the 4 days of stepwise food reintroduction, even when subjects stopped their antihypertensive medication. REGISTRATION: URL: https://www.drks.de/drks_web/; Unique identifier: DRKS00010111. John Wiley and Sons Inc. 2020-11-23 /pmc/articles/PMC7763762/ /pubmed/33222606 http://dx.doi.org/10.1161/JAHA.120.018649 Text en © 2020 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Research
Grundler, Franziska
Mesnage, Robin
Michalsen, Andreas
Wilhelmi de Toledo, Françoise
Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting
title Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting
title_full Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting
title_fullStr Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting
title_full_unstemmed Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting
title_short Blood Pressure Changes in 1610 Subjects With and Without Antihypertensive Medication During Long‐Term Fasting
title_sort blood pressure changes in 1610 subjects with and without antihypertensive medication during long‐term fasting
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7763762/
https://www.ncbi.nlm.nih.gov/pubmed/33222606
http://dx.doi.org/10.1161/JAHA.120.018649
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