DIET, WEIGHT LOSS AND HYPERTENSION

It looks like the doctors at Duke University, Durham must be very keen on diet, weight loss and hypertension. They have two papers published in the Archives of Internal Medicine this month on life style modification and blood pressure lowering. Dr James Blumenthal and colleagues published the followup on ENCORE in the Jan 5th issue of the Arch., and Dr William Yancy and colleagues published their study on carb. restriction with weight loss as compared with low fat diet and orlistat and blood pressure in the 25th January issue of the Archives of Internal medicine.
Of course both the studies point to the fact that if one is prepared to go on the DASH diet ( a diet low in salt and rich in greens and fruits ), with weight loss, the BP will come down significantly and if one is prepared to go on a low carb. diet, with weight loss the BP will come down. The slight surprise is that if one goes on a low fat diet, and use of orlistat ( a fat reducing, weight reducing agent by Roche ), your weight will come down, but the BP does not come down as much as those on low carb. diet and weight loss.
I suppose the message that I got was that diet and weight loss lowers BP and should always be advocated by physicians as a important component in our fight against hypertension. In my opinion, drugs must always be used with life style modification and, never alone. Sometimes in pre-hypertension, life style modification with weight loss ( especially in those obesed ) is enough to control BP. I do this all the time in my clinic. It is indeed very gratifying to see an obesed patient with pre-hypertension, lose weight and lose high BP. He feels happier and fitter and you feel that you have help someone in a very basic way. Maybe most of us should start a life-style counselling service and provide this service as a means to tackle this problem of hypertension.
Incidentally, this weekend ( I am told ), is the Annual Scientific meeting of the Malaysian Society of Hypertension. Lets see what new things come out of this meeting.
Remmember, lose your weight and lose your hypertension.