Weight Loss Interventions

Intentional weight loss is recognised in major international hypertension guidelines as an effective non-pharmacological strategy for reducing blood pressure. A Cochrane review of weight-reducing drugs in adults with essential hypertension found a mean SBP reduction of −2.6 mm Hg and a mean DBP reduction of −2.0 mm Hg. Greater weight loss is associated with greater reductions in blood pressure and may reduce reliance on antihypertensive and metabolic medications. The AHA/ACC/Obesity Society 2013 guideline recommends losing 5–10% of baseline body weight within 6 months through combined diet, physical activity, and behavioural strategies. Comparative effectiveness of different weight loss interventions in patients with hypertension has not yet been established. A meta-analysis of energy restriction, exercise, or both found approximately 1 mm Hg blood pressure reduction for every 1 kg of weight lost in an obese population. Dietary approaches targeting hypertension, such as DASH or sodium reduction, are eligible only if the study reports a decrease in body weight. Eligible weight loss interventions include pharmacotherapy, bariatric surgery, diet, exercise, behavioural therapy, and co…