Compliance with weight reduction in hypertensive patients.

There is a correlation between body weight or obesity and blood pressure in the population, and most hypertensive patients are overweight. Weight reduction of 6 kg or more reduces blood pressure by an average of 15/9 mmHg even if the ideal body weight is not attained, and this is not explained by changes in salt intake or by measurement artefact due to the fat arm. Some form of calorie restriction is the mainstay of managing obesity in hypertensive patients, and those referred to a dietitian lose significantly more weight tham those given a diet sheet by a doctor or given no specific advice. About 50% of patients referred to a dietitian reduce their body weight by 6 kg or more. There is a tendency to regain weight in the long-term, but after four years more than one third of patients remain at least 6 kg below their initial weight. Men seem to lose relatively little weight whether or not they are referred to a dietitian, whereas women referred to a dietitian achieve substantial and sustained weight loss.