Impact of Diet and Lifestyle Modification and Weight Reduction on Essential Hypertension

Abstract

Objectives: This study was to assess the impact of diet and lifestyle modification with weight reduction on blood pressure in patients with essential hypertension and to impart awareness regarding the importance of dietary modifications, physical exercise, and weight reduction in controlling or reversing high blood pressure and prevention of end-organ damage. Methods: This was a prospective observational study among overweight or obese hypertensives. We included 60 consecutive patients, who after sticking to the diet and lifestyle advice achieved weight reduction. They all were overweight, or had a history of weight gain, and had hypertension, or were newly diagnosed to have persistent hypertension. They were motivated to achieve weight reduction and educated about healthy eating habits using diet charts and tips for lifestyle modifications. Sixty such consecutive subjects, without any secondary causes for hypertension, and who complied with the diet and lifestyle advised, and thus achieved weight reduction only were subjected to statistical analysis. Those who did not achieve weight reduction were not taken for analysis Results: 90 % of the subjects had their BMI above normal and the remaining 10% of subjects had an upper range of normal BMI, but all of them gave a history of weight gain. The majority of the subjects were having faulty dietary habits with increased carbohydrate intake as the primary reason for weight gain, besides having inadequate vegetables, fruits and protein intake, along with 15% consuming junk food on a daily basis. After lifestyle intervention, weight reduction was achieved in all the subjects studied, and there was a significant reduction in both systolic and diastolic blood pressures with the weight loss achieved, and it was statistically significant. The association of decrease in SBP with a decrease in weight was significant with a p-value of <0.001. The mean initial systolic blood pressure was 154.13 mmHg (SD 13.31), and the follow up mean was 137.33 mmHg (SD 12.87). The mean decrease in SBP was 16.8mmHg, and the mean change in weight was 9.4 Kg. Most of the hypertensives had their drug number or dose decreased and some of them had their drugs stopped completely. Conclusions: Educating the subjects on balanced diet with restriction of carbohydrates with increased intake of vegetables, adequate fruits, ensuring adequate protein and adequate water intake was the key intervention. The results of the study strongly pointed towards the inevitable role diet, lifestyle and weight reduction had on the achievement of blood pressure control and even reversal of hypertension. Faulty dietary habits with excessive calorie intake, decreased vegetables and fruits, low physical activity and sedentary nature of work contributed to weight gain. Both systolic and diastolic BP decreased on weight reduction implying thereby weight gain as the primary cause for both. Awareness regarding the disease and its complications was very low. In addition, dietary malpractices were detected and halted, and this reinforced the positive results. It also had a favorable impact on the comorbidities they suffered from.