Weight reduction in the management of hypertension: Epidemiologic and mechanistic evidence

1986 ◽  
Vol 64 (6) ◽  
pp. 818-824 ◽  
Author(s):  
Efrain Reisin
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Weight Control ◽  
Sodium Intake ◽  
Close Association ◽  
Peripheral Resistance ◽  
Volume Ratio ◽  
Epidemiological Studies ◽  
Left Ventricular ◽  
Normal Weight

A number of studies have established a close association between increased body mass and elevated blood pressure. The presence of obesity in hypertensive subjects is associated with some hemodynamic, metabolic, and endocrinic characteristics: an increased intravascular volume with a high intracellular body water/interstitial fluid volume ratio, increased cardiac output, stroke volume, and left ventricular work while peripheral resistance was reduced or normal. Weight loss of at least 10 kg can reduce blood pressure independently of changes in sodium intake in obese persons of both sexes with mild, moderate, or severe high blood pressure. The fall in arterial pressure in obese hypertensives after weight loss may reverse many of the previously mentioned altered findings and underscore previous epidemiological studies that have shown that weight control could be an important measure in the treatment of hypertension.

scholarly journals The Effects of Short-Term Changes in Sodium Intake on Plasma Marinobufagenin Levels in Patients with Primary Salt-Sensitive and Salt-Insensitive Hypertension

Nutrients ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1502
Author(s):  
Katarzyna Łabno-Kirszniok ◽  
Agata Kujawa-Szewieczek ◽  
Andrzej Wiecek ◽  
Grzegorz Piecha
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Sodium Intake ◽  
Left Ventricular ◽  
Primary Hypertension ◽  
Dietary Sodium ◽  
Sodium Restriction ◽  
Short Term ◽  
Salt Loading ◽  
Dietary Sodium Restriction

Increased marinobufagenin (MBG) synthesis has been suggested in response to high dietary salt intake. The aim of this study was to determine the effects of short-term changes in sodium intake on plasma MBG levels in patients with primary salt-sensitive and salt-insensitive hypertension. In total, 51 patients with primary hypertension were evaluated during acute sodium restriction and sodium loading. Plasma or serum concentrations of MBG, natriuretic pro-peptides, aldosterone, sodium, potassium, as well as hematocrit (Hct) value, plasma renin activity (PRA) and urinary sodium and potassium excretion were measured. Ambulatory blood pressure monitoring (ABPM) and echocardiography were performed at baseline. In salt-sensitive patients with primary hypertension plasma MBG correlated positively with diastolic blood pressure (ABPM) and serum NT-proANP concentration at baseline and with serum NT-proANP concentration after dietary sodium restriction. In this subgroup plasma MBG concentration decreased during sodium restriction, and a parallel increase of PRA was observed. Acute salt loading further decreased plasma MBG concentration in salt-sensitive subjects in contrast to salt insensitive patients. No correlation was found between plasma MBG concentration and left ventricular mass index. In conclusion, in salt-sensitive hypertensive patients plasma MBG concentration correlates with 24-h diastolic blood pressure and dietary sodium restriction reduces plasma MBG levels. Decreased MBG secretion in response to acute salt loading may play an important role in the pathogenesis of salt sensitivity.

scholarly journals Weight-Loss Behaviors of Avoiding Between Meal and Midnight Snack in Teenagers Associated with Gestational Diabetes: The Japan Environment and Children’s Study

2021 ◽  
Author(s):  
Marina Minami ◽  
Takafumi Watanabe ◽  
Masamitsu Eitoku ◽  
Nagamasa Maeda ◽  
Mikiya Fujieda ◽  
...  
Keyword(s):  
Weight Loss ◽  
Gestational Diabetes ◽  
Odds Ratio ◽  
Weight Control ◽  
Dietary Habits ◽  
Normal Weight ◽  
Crude Odds Ratio ◽  
Live Births ◽  
Weight Loss Behavior ◽  
Previous Cesarean

Abstract Background: Dietary habits and weight control before pregnancy are important in preventing gestational diabetes. This study aims to examine whether the weight-loss behavior of avoiding between meal and midnight snacks in teenagers is associated with subsequent gestational diabetes mellitus (GDM).Methods: A total of 89,227 (85.7% of the total) mother-infant pairs of live births were included in our study of the Japan Environment and Children's Study (JECS). In the second or third trimesters, participants were asked to report their weight-loss behaviors during their teenage years. Response items included avoidance of meals and midnight snacking. The main outcome of our study was the prevalence of GDM.Results: Overall, 2,066 (2.3%) participants had GDM. Relative to those without GDM, women with GDM were older, were smokers, had a higher prevalence of hypertension, previous cesarean delivery, mental illness, and higher body mass index (BMI). Weight-loss behavior in their teenage years was associated with a decreased risk of GDM (unadjusted crude odds ratio, 0.83; 95% confidence interval [CI]: 0.76–0.91), model 1 (adjusted odds ratio [aOR], 0.86; 95% CI: 0.79–0.94), and model 2 (aOR, 0.80; 95% CI: 0.73–0.88). Weight-loss behavior in teens was associated with a decreased risk of GDM in the normal weight [aOR, 0.79; 95% CI: 0.70–0.89) and overweight (aOR, 0.82; 95% CI: 0.69–0.98) groups.Conclusions: The results suggest that weight-loss behaviors of avoiding in-between meals and midnight snacking as teenagers are associated with a decreased risk of developing GDM.

scholarly journals Sodium Intake and Target Organ Damage in Hypertension—An Update about the Role of a Real Villain

2020 ◽  
Vol 17 (8) ◽  
pp. 2811 ◽  
Author(s):  
Federica Nista ◽  
Federico Gatto ◽  
Manuela Albertelli ◽  
Natale Musso
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Sodium Intake ◽  
Target Organ Damage ◽  
Organ Damage ◽  
Left Ventricular ◽  
Target Organ ◽  
Main Role ◽  
Sodium Consumption

Salt intake is too high for safety nowadays. The main active ion in salt is sodium. The vast majority of scientific evidence points out the importance of sodium restriction for decreasing cardiovascular risk. International Guidelines recommend a large reduction in sodium consumption to help reduce blood pressure, organ damage, and cardiovascular risk. Regulatory authorities across the globe suggest a general restriction of sodium intake to prevent cardiovascular diseases. In spite of this seemingly unanimous consensus, some researchers claim to have evidence of the unhealthy effects of a reduction of sodium intake, and have data to support their claims. Evidence is against dissenting scientists, because prospective, observational, and basic research studies indicate that sodium is the real villain: actual sodium consumption around the globe is far higher than the safe range. Sodium intake is directly related to increased blood pressure, and independently to the enlargement of cardiac mass, with a possible independent role in inducing left ventricular hypertrophy. This may represent the basis of myocardial ischemia, congestive heart failure, and cardiac mortality. Although debated, a high sodium intake may induce initial renal damage and progression in both hypertensive and normotensive subjects. Conversely, there is general agreement about the adverse role of sodium in cerebrovascular disease. These factors point to the possible main role of sodium intake in target organ damage and cardiovascular events including mortality. This review will endeavor to outline the existing evidence.

scholarly journals Sodium Intake and Hypertension

Nutrients ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 1970 ◽  
Author(s):  
Grillo ◽  
Salvi ◽  
Coruzzi ◽  
Salvi ◽  
Parati
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Sodium Intake ◽  
Peripheral Resistance ◽  
Dietary Sodium ◽  
Dietary Salt ◽  
High Sodium ◽  
Close Relationship ◽  
And Function ◽  
Modest Reduction

The close relationship between hypertension and dietary sodium intake is widely recognized and supported by several studies. A reduction in dietary sodium not only decreases the blood pressure and the incidence of hypertension, but is also associated with a reduction in morbidity and mortality from cardiovascular diseases. Prolonged modest reduction in salt intake induces a relevant fall in blood pressure in both hypertensive and normotensive individuals, irrespective of sex and ethnic group, with larger falls in systolic blood pressure for larger reductions in dietary salt. The high sodium intake and the increase in blood pressure levels are related to water retention, increase in systemic peripheral resistance, alterations in the endothelial function, changes in the structure and function of large elastic arteries, modification in sympathetic activity, and in the autonomic neuronal modulation of the cardiovascular system. In this review, we have focused on the effects of sodium intake on vascular hemodynamics and their implication in the pathogenesis of hypertension.

scholarly journals Effect of weight loss on blood pressure and drug consumption in normal weight patients.

Hypertension ◽  
1986 ◽  
Vol 8 (3) ◽  
pp. 223-228 ◽  
Author(s):  
Y Imai ◽  
K Sato ◽  
K Abe ◽  
S Sasaki ◽  
M Nihei ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Weight Loss ◽  
Normal Weight ◽  
Drug Consumption

Exercise training modifies myocardial mitochondria and myofibril growth in spontaneously hypertensive rats

1985 ◽  
Vol 248 (1) ◽  
pp. H8-H14
Author(s):  
R. P. Crisman ◽  
R. J. Tomanek
Keyword(s):  
Blood Pressure ◽  
Exercise Training ◽  
Spontaneously Hypertensive Rats ◽  
Pressure Overload ◽  
Volume Ratio ◽  
Volume Density ◽  
Left Ventricular ◽  
Hypertensive Rats ◽  
Spontaneously Hypertensive ◽  
Wistar Kyoto

We tested the hypothesis that exercise training provides a stimulus that could modify the decrement in mitochondria-to-myofibril volume ratio characteristic of myocardial cells hypertrophied in response to a pressure overload. Spontaneously hypertensive rats (SHR) were trained 5 days/wk on a treadmill at 70-90% maximal VO2 between the ages of 6 and 16 wk corresponding to the development of hypertension and cardiac hypertrophy. The training program increased maximal VO2 and effected a resting bradycardia but did not alter blood pressure, left ventricular hypertrophy, or peak cardiac output. Our stereological data from electron micrographs shows that the decrement in mitochondrial volume density and the increase in myofibril volume density characteristic of SHR compared with their normotensive controls (WKY, Wistar-Kyoto rats) were reversed. Thus the relative volumes of mitochondria and myofibrils and their ratio in trained SHR were similar to those of the WKY group. The similarity was noted in myocytes from both the subepicardium and subendocardium. These data suggest that exercise training facilitates a proportional growth of energy-producing and energy-consuming organelles in SHR and that this effect is not secondary to modification of blood pressure or left ventricular mass.

Hemodynamic alterations in chronically conscious unrestrained diabetic rats

1987 ◽  
Vol 252 (5) ◽  
pp. H900-H905 ◽  
Author(s):  
L. F. Carbonell ◽  
M. G. Salom ◽  
J. Garcia-Estan ◽  
F. J. Salazar ◽  
M. Ubeda ◽  
...  
Keyword(s):  
Weight Control ◽  
Insulin Treatment ◽  
Cardiac Contractility ◽  
Peripheral Resistance ◽  
Left Ventricular Pressure ◽  
Diabetic Rats ◽  
Left Ventricular ◽  
Diabetic State ◽  
Hemodynamic State ◽  
Male Wistar Rats

Important cardiovascular dysfunctions have been described in streptozotocin (STZ)-diabetic rats. To determine the influence of these changes on the hemodynamic state and whether insulin treatment can avoid them, different hemodynamic parameters, obtained by the thermodilution method, were studied in STZ-induced (65 mg/kg) diabetic male Wistar rats, as well as in age-control, weight-control, and insulin-treated diabetic ones. All rats were examined in the conscious, unrestrained state 12 wk after induction of diabetes or acidified saline (pH 4.5) injection. At 12 wk of diabetic state most important findings were normotension, high blood volume, bradycardia, increase in stroke volume, cardiac output, and cardiosomatic ratio, and decrease in total peripheral resistance and cardiac contractility and relaxation (dP/dtmax and dP/dtmin of left ventricular pressure curves). The insulin-treated diabetic rats did not show any hemodynamic differences when compared with the control animals. These results suggest that important hemodynamic alterations are present in the chronic diabetic state, possibly conditioning congestive heart failure. These alterations can be prevented by insulin treatment.

scholarly journals Heritability of Hemodynamic Reactivity to Laboratory Stressors in a Homogenous Arab Population: ‘Oman Family Study’

2009 ◽  
Vol 12 (6) ◽  
pp. 541-548 ◽  
Author(s):  
Mohammed O. Hassan ◽  
Riad A. Bayoumi ◽  
Juan C. Lopez-Alvarenga ◽  
Harold Snieder ◽  
Deepali Jaju ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Reactivity ◽  
Acute Stress ◽  
Univariate Analysis ◽  
Peripheral Resistance ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Arab Population ◽  
Heritability Estimates ◽  
Ventricular Ejection Time

AbstractBackground:Exaggerated cardiovascular reactivity to stressful stimuli may be a risk factor for the development of hypertension. The genetic influence on blood pressure (BP) reactivity to stress and its control mechanisms has been receiving considerable support. This study aims at examining the heritability of BP and its intermediate hemodynamic phenotypes to acute stress in a homogeneous Arab population.Methods:Parameters were computed from continuous BP, electrocardiography and impedance cardiography measurements, during rest, word conflict (WCT) and cold pressor (CPT) tests. Heritability estimates (h2) were obtained using the variance components-based approach implemented in the SOLAR software package.Results:Reactivity scores for WCT and CPT increased significantly (P< .05) for systolic (SBP), diastolic (DBP), heart rate (HR), cardiac output (CO), and total peripheral resistance (TPR). They decreased significantly (P< .05) for stroke volume (SV), left ventricular ejection time (LVET), end diastolic (EDI) and cardiac contractility (IC) indices. Univariate analysis detected heritability estimates that ranged from 0.19–0.35 for rest, 0.002–0.40 for WCT and 0.08–0.35 for CPT.Conclusion:In this unique cohort, resting as well as challenged cardiovascular phenotypes are significantly influenced by additive genetic effects. Heritability estimates for resting phenotypes are in a relatively narrow range, while h2for their reactivity is somewhat broader with lower estimates. Further analyses of this study may offer important opportunities for gene finding in hypertension.What is Known About the Topic:(1) cardiovascular reactivity to stress predicts cardiovascular disease; (2) genetic susceptibility plays an important role in stress reactivity. Family studies using the cold pressure test reported significant heritability for blood pressure.What this Study Adds:(1) this cohort is from five highly consanguineous isolated Arab pedigrees with genetically verified genealogical records and environmental homogeneity; (2) This is the first study to estimate heritability of detailed intermediate hemodynamic phenotypes that make up normal blood pressure.

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