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Br Med J (Clin Res Ed). 1984 January 7; 288(6410): 11–14.
PMCID: PMC1444105

Blood pressure control during weight reduction in obese hypertensive men: separate effects of sodium and energy restriction.


The separate and combined effects of dietary energy and sodium restriction on regulation of blood pressure were investigated in 30 middle aged obese men with essential hypertension attending the outpatient department. In group 1 (n = 15) a basal period with no dietary restriction was followed by a period taking an energy reduced diet (5.1 MJ; 1230 kcal), the sodium intake being supplemented and hence unchanged (1:ErSn). In group 2 (n = 15) the basal period preceded a control period with no intervention, which was followed by taking a diet restricted in energy (5.1 MJ; 1220 kcal) and sodium (2:ErSr). During period 1:ErSn there were reductions in heart rate and urinary noradrenaline output but not in systolic or diastolic blood pressure. Body weight decreased by 4.9-11.7 kg and urinary sodium excretion did not change. In period 2:ErSr urinary sodium output was reduced by 81.4 (SEM 17.8) mmol(mEq)/24 h and there was a weight loss of 8.2 (SEM 0.7) kg. Systolic and diastolic blood pressures fell significantly, as did the heart rate and urinary noradrenaline excretion. These results show that in hypertensive obese men a moderate weight reducing diet decreases indices of sympathetic nervous system activity. Reduction of blood pressure to the normotensive range was observed only when there was a concomitant restriction of sodium intake.

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Selected References

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  • Chiang BN, Perlman LV, Epstein FH. Overweight and hypertension. A review. Circulation. 1969 Mar;39(3):403–421. [PubMed]
  • Genuth SM, Castro JH, Vertes V. Weight reduction in obesity by outpatient semistarvation. JAMA. 1974 Nov 18;230(7):987–991. [PubMed]
  • Heyden S. The workinghman's diet. II. Effect of weight reduction in obese patients with hypertension, diabetes, hyperuricemia and hyperlipidemia. Nutr Metab. 1978;22(3):141–159. [PubMed]
  • Reisin E, Abel R, Modan M, Silverberg DS, Eliahou HE, Modan B. Effect of weight loss without salt restriction on the reduction of blood pressure in overweight hypertensive patients. N Engl J Med. 1978 Jan 5;298(1):1–6. [PubMed]
  • Tuck ML, Sowers J, Dornfeld L, Kledzik G, Maxwell M. The effect of weight reduction on blood pressure, plasma renin activity, and plasma aldosterone levels in obese patients. N Engl J Med. 1981 Apr 16;304(16):930–933. [PubMed]
  • Ramsay LE, Ramsay MH, Hettiarachchi J, Davies DL, Winchester J. Weight reduction in a blood pressure clinic. Br Med J. 1978 Jul 22;2(6132):244–245. [PMC free article] [PubMed]
  • DAHL LK, SILVER L, CHRISTIE RW. The role of salt in the fall of blood pressure accompanying reduction in obesity. N Engl J Med. 1958 Jun 12;258(24):1186–1192. [PubMed]
  • Eliahou HE, Iaina A, Gaon T, Shochat J, Modan M. Body weight reduction necessary to attain normotension in the overweight hypertensive patient. Int J Obes. 1981;5 Suppl 1:157–163. [PubMed]
  • LINDBERG W, NATVIG H, RYGH A, SVENDSEN K. Høyde- og vektundersøkelser hos voksne menn og kvinner; forslag til nye norske høyde-vektnormer. Tidsskr Nor Laegeforen. 1956 Jun 1;76(11):361–368. [PubMed]
  • Anderson O, Berglund G, Hansson L, Sannerstedt R, Sivertsson R, Wikstrand J, Wilhelmsen L. Organization and efficacy of an out-patient hypertension clinic. Acta Med Scand. 1978;203(5):391–398. [PubMed]
  • Bruce A, Andersson M, Arvidsson B, Isaksson B. Body composition. Prediction of normal body potassium, body water and body fat in adults on the basis of body height, body weight and age. Scand J Clin Lab Invest. 1980 Sep;40(5):461–473. [PubMed]
  • von EULER U, LISHAJKO F. The estimation of catechol amines in urine. Acta Physiol Scand. 1959 Mar 31;45:122–132. [PubMed]
  • Isaksson B, Lindholm B, Sjögren B. Dermal losses of nutrients and their significance for human metabolic balance studies. Acta Med Scand Suppl. 1966;445:416–420. [PubMed]
  • Altschul AM, Grommet JK. Sodium intake and sodium sensitivity. Nutr Rev. 1980 Dec;38(12):393–402. [PubMed]
  • Simić BS, Dimitrijević D, Sekulović I, Trajković L. The relation of obesity onset age and the effect of reducing diet on blood pressure. Acta Med Iugosl. 1981;35(2):95–102. [PubMed]
  • Puska P, Iacono JM, Nissinen A, Korhonen HJ, Vartianinen E, Pietinen P, Dougherty R, Leino U, Mutanen M, Moisio S, et al. Controlled, randomised trial of the effect of dietary fat on blood pressure. Lancet. 1983 Jan 1;1(8314-5):1–5. [PubMed]
  • Iacono JM, Judd JT, Marshall MW, Canary JJ, Dougherty RM, Mackin JF, Weinland BT. The role of dietary essential fatty acids and prostaglandins in reducing blood pressure. Prog Lipid Res. 1981;20:349–364. [PubMed]
  • Criqui MH, Wallace RB, Mishkel M, Barrett-Connor E, Heiss G. Alcohol consumption and blood pressure. The lipid research clinics prevalence study. Hypertension. 1981 Sep-Oct;3(5):557–565. [PubMed]
  • Krotkiewski M, Mandroukas K, Sjöström L, Sullivan L, Wetterqvist H, Björntorp P. Effects of long-term physical training on body fat, metabolism, and blood pressure in obesity. Metabolism. 1979 Jun;28(6):650–658. [PubMed]
  • Maxwell MH, Waks AU, Schroth PC, Karam M, Dornfeld LP. Error in blood-pressure measurement due to incorrect cuff size in obese patients. Lancet. 1982 Jul 3;2(8288):33–36. [PubMed]
  • Dunne JF. Variation of blood-pressure in untreated hypertensive outpatients. Lancet. 1969 Feb 22;1(7591):391–392. [PubMed]
  • Silman AJ, Locke C, Mitchell P, Humpherson P. Evaluation of the effectiveness of a low sodium diet in the treatment of mild to moderate hypertension. Lancet. 1983 May 28;1(8335):1179–1182. [PubMed]
  • Wikstrand J, Berglund G, Wilhelmsen L, Wallentin I. Orthogonal electrocardiogram, apex cardiogram, and atrial sound in normotensive and hypertensive 50-year-old men. Br Heart J. 1976 Aug;38(8):779–789. [PMC free article] [PubMed]
  • Sowers JR, Nyby M, Stern N, Beck F, Baron S, Catania R, Vlachis N. Blood pressure and hormone changes associated with weight reduction in the obese. Hypertension. 1982 Sep-Oct;4(5):686–691. [PubMed]
  • MacGregor GA, Smith SJ, Markandu ND, Banks RA, Sagnella GA. Moderate potassium supplementation in essential hypertension. Lancet. 1982 Sep 11;2(8298):567–570. [PubMed]
  • Skrabal F, Auböck J, Hörtnagl H. Low sodium/high potassium diet for prevention of hypertension: probable mechanisms of action. Lancet. 1981 Oct 24;2(8252):895–900. [PubMed]

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