Low-Calorie Diet May Lower Blood Pressure in Some With Type 2
Following a low-calorie diet for weight loss in an attempt to achieve remission of type 2 diabetes may also be effective at lowering blood pressure, allowing some people to stop taking some or all of their medications for high blood pressure, according to a new study published in the journal Diabetologia.
Type 2 diabetes is often seen along with other health problems — including excess body fat around the waist, high blood pressure, and abnormal blood lipid (cholesterol and triglyceride) levels — as part of a cluster of conditions known as metabolic syndrome. People with metabolic syndrome are at higher risk for many different poor health outcomes, including heart disease and stroke. While the common approach to managing metabolic syndrome is to tackle each of the different elements separately with drugs, interventions that lead to improvements in more than one area may be especially beneficial, since all of the different elements of the syndrome are likely to contribute to heart and stroke risk in different ways. Lifestyle changes, in particular, may lead to improvements in more than one area of metabolic syndrome.
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For the latest study, researchers were interested in whether following a low-calorie diet — aimed at inducing weight loss and remission (reversal) of type 2 diabetes, with the goal of no longer needing glucose-lowering medications — could also lead to improvement in blood pressure that allowed people to safely stop taking blood-pressure-lowering drugs (also known as antihypertensive drugs). The participants were 143 people with type 2 diabetes, all of whom followed a low-calorie diet in which at first, they replaced all food with a diet replacement formula that provided 830 calories per day. Out of the 143 participants, 78 (55%) were taking drugs for blood pressure, and were supposed to stop taking all blood pressure drugs when they began this total diet replacement. In practice, though, only 65 of these participants actually stopped taking all blood pressure drugs, while another four stopped taking some of these drugs, for a total of 69. All participants had their blood pressure monitored regularly, and started taking blood pressure medications again if their blood pressure didn’t drop or went up enough to require this.
Low-calorie diet lowered blood pressure in some participants
Among the 69 participants who stopped taking all or some blood pressure drugs, none experienced an immediate change in blood pressure within the first week after starting total diet replacement — good news, since it meant that no one’s blood pressure shot up when they stopped taking medications. After that, while no one experienced a dramatic rise in blood pressure, 19 of the 69 (28%) started taking a drug again when their blood pressure went up, mostly within the first three to seven weeks. This rise in blood pressure occurred despite the fact that participants were losing weight. After 24 months of following a low-calorie diet — only the first few weeks involved total diet replacement — 50 of the 69 participants (72%) had gone back to taking at least one blood pressure drug.
Out of 53 study participants (37% of the whole group of 143) who achieved diabetes remission after 24 months — and lost an average of 11.4 kilograms (25.1 pounds) — 31 had been taking a drug for high blood pressure before the study began. Out of these 31, 27 stopped taking all or some of their blood pressure drugs at the beginning of the study as they were supposed to, and 15 of these 27 (56%) needed to start taking a blood pressure drug again during the next 24 months. In other words, participants who achieved diabetes remission were somewhat more likely to remain off their blood pressure drugs compared with those who didn’t achieve diabetes remission, but most still needed to start taking these drugs again.
“Replacing antihypertensive medications with a…diet to induce weight loss reduces [blood pressure] substantially,” the researchers concluded, adding that blood pressure “should be monitored regularly, particularly for those taking two or more antihypertensives, as over two-thirds will require reintroduction of some medications. Long-term support to maintain weight loss is vital.”
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