Long-term effects of weight-reducing interventions in hypertensive patients: systematic review and meta-analysis

Arch Intern Med. 2008 Mar 24;168(6):571-80. doi: 10.1001/archinte.168.6.571.


Weight loss is recommended in all major guidelines for antihypertensive therapy. We searched for randomized controlled trials investigating the effects of weight-reducing diets, pharmacologic substances, and invasive interventions for weight reduction on patient-relevant end points and blood pressure (BP) in patients with essential hypertension. No information on the effects on patient-relevant end points was available. Patients assigned to weight loss diets, orlistat, or sibutramine reduced their body weight more effectively than did patients in the usual care/placebo groups. Reduction of BP was higher in patients treated with weight loss diets (systolic BP [SBP]: weighted mean difference [WMD], -6.3 mm Hg; diastolic BP [DBP]: WMD, -3.4 mm Hg) or orlistat (SBP: WMD, -2.5 mm Hg; DBP: WMD, -2.0 mm Hg). Systolic BP increased with sibutramine treatment (WMD, 3.2 mm Hg). In patients with essential hypertension, therapy with a weight loss diet or orlistat resulted in reductions in body weight and BP. Although sibutramine treatment reduced body weight, it did not lower BP.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Appetite Depressants / therapeutic use*
  • Blood Pressure / drug effects
  • Cyclobutanes / therapeutic use
  • Humans
  • Hypertension / complications
  • Hypertension / therapy*
  • Lactones / therapeutic use
  • Obesity / complications
  • Obesity / therapy*
  • Orlistat
  • Time Factors
  • Treatment Outcome
  • Weight Loss / drug effects*


  • Appetite Depressants
  • Cyclobutanes
  • Lactones
  • Orlistat
  • sibutramine