Eliahou H E, Iaina A, Gaon T, Shochat J, Modan M
Int J Obes. 1981;5 suppl 1:157-63.
All 212 patients with essential hypertension and an overweight of at least 10 per cent in excess of ideal body weight, referred to out clinic in the years 1975-1979, were included in this study. The patients were advised to take a balanced low-calorie (about 1080 kcal/day) diet containing 83 g carbohydrates, 41.5 g fat and 85 g proteins. They were advised to eat salt freely. There were 40 patients who had four clinic visits or less and 49 others who could not follow their diet. Therefore the compliance-failure rate was 89/212, ie 42 per cent. Decrease in body weight resulted in a significant decrease in blood pressure, despite free ingestion of salt and with 24-h urine sodium which was not different from that obtained before dietary therapy was started. Over two-thirds of the compliant patients will achieve normal blood pressure with a loss of only one-half of their weight excess, even if at this point they are still overweight. In the group receiving no diuretic or any other anti-hypertensive therapy, 82.6 percent reached normal systolic blood pressures and 78.3 per cent reached normal diastolic blood pressures, but only 31/38 reached a body weight within 10 per cent of ideal body weight. It is concluded that most of overweight hypertensive patients can attain a normal blood pressure by reducing body weight, long before achieving the ideal weight.
1975年至1979年间转诊至我院门诊的所有212例原发性高血压患者，体重超过理想体重至少10%，均纳入本研究。建议患者采用均衡的低热量（约1080千卡/天）饮食，含83克碳水化合物、41.5克脂肪和85克蛋白质。建议他们随意摄入盐分。有40例患者门诊就诊次数为4次或更少，另有49例患者无法遵循饮食建议。因此，依从性失败率为89/212，即42%。尽管自由摄入盐分且24小时尿钠与开始饮食治疗前无差异，但体重减轻导致血压显著下降。超过三分之二的依从患者仅通过减轻一半超重体重就能使血压恢复正常，即使此时他们仍超重。在未接受利尿剂或任何其他抗高血压治疗的组中，82.6%的患者收缩压恢复正常，78.3%的患者舒张压恢复正常，但只有31/38的患者体重达到理想体重的±10%。得出的结论是，大多数超重高血压患者在远未达到理想体重之前，通过减轻体重就能使血压恢复正常。
