Effect of one-day intermittent fasting on 24-hour blood pressure profile in hypertensive and normotensive patients with overweight and obesity

Abstract

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): National Academy of Medical Science of Ukraine Background The modification of eating behavior is an integral part of cardiovascular disease prevention. Intermittent fasting is a modern approach towards diet correction. However, insufficient data exists on its effect and safety on daily blood pressure and lipids. The aim of this paper was to assess the response of blood pressure, blood lipids and creatinine to acute intermittent fasting (IF) in hypertensive and normotensive patients with overweight and obesity. Methods A cohort of 65 hypertensive patients and 45 young normotensive patients with overweight and obesity included. All patients were monitored for 24 hours by Ambulatory Blood Pressure monitoring by ABMP50 Machine. All hypertensive patients were on stable antihypertensive therapy for at least 3 months and had met target office blood pressure levels. Fasting glucose (FG), blood lipids, creatinine, uric acid and high sensitive C-reactive protein (hCRP) were measured before and after fasting. All patients were asked to fast (F) for 16 hours for the first time in their lives. At the end of the fasting period, all participants in the study rated their subjective state from 1 to 10. Statistical analyses were conducted by IBM SPSS Statistics 22. Results The reaction of blood pressure on intermitted fasting was similar in both groups. Decrease of day systolic blood pressure (SBP) as well as increase of night diastolic blood pressure (DPB) was observed in both groups (TABLE 1). No significant changes of daily BP were observed in normotensive patients. Daily heart rate increased in 1st group by 1,5% (p=0.003) and decreased in 2nd group by 4,2% (p=0,002). At the same time daily SBP decreased in the group of hypertensive patients. The hypertension group (65 patients) rated their subjective state higher than 5 points and expressed that fasting was easy for them, age median 57 (51:61) years old. The normotensive group rated themselves below 5 points and expressed the difficulty of fasting and low quality of sleep, age median 26 (25:45) years old. The median BMI in 1st group 32,1 (30:35) in 2nd group 27,4 (25:30) kg/m2. The mean FG before fasting in the 1st group was 5,45(±0,61) mmol/l in the 2nd group was 4,75 (±0,55) mmol/l and after IF in the 1st group 5,36 (±0,73) mmol/l in the 2nd group 4,58 (±0,64) mmol/l (p>0.05). In hypertension group the mean of hCRP decreased from 9.95±8.02 to 4.68±2.88 (p=0.04). The level of blood creatinine and GFR had not significant changes. Conclusion One-day intermittent fasting leads to a change in blood pressure, does not cause hypotension, and is tolerated favorably in obese patients with hypertension on stable antihypertensive therapy.