Abstract 12451: Achievement of Weight Loss With Hypertension Control Among Adults With Incident Hypertension
Background: Being overweight or obese independently contributes to the development of target organ damage among adults with hypertension. Weight loss and hypertension control are critical to reduce morbidity in this population. The purpose of this study is to evaluate rates and predictors of weight loss among adults with incident hypertension who achieve hypertension control.
Methods: We conducted an analysis of overweight or obese ≥18 year-olds with incident hypertension receiving regular primary care in a large, academic group practice from 2008-2011. Patients with a previous hypertension diagnosis or antihypertensive prescription were excluded. Patients (n=4,913) were followed until hypertension control. Patients were classified by body mass index (BMI) at baseline as overweight or class I, II, or III obese. Weight was assessed at study entry and within 30 days of achieving hypertension control. Kaplan-Meier analysis estimated the probability of any weight loss (≥2.0 kg). Cox proportional-hazard models (HR; 95% CI) were fit to identify predictors of weight loss at the time of hypertension control.
Results: Patients were followed a mean 12.4 (SD 10.3) months. Overall, 32% (n=1,567) had ≥2.0 kg weight loss at the time of hypertension control, almost half (n=718) lost ≥5.0 kg. Patients with lower BMI at study entry had lower weight loss rates at the time of hypertension control. Compared to class III obese (BMI ≥40 kg/m2), overweight patients had a 37% lower rate of losing >2.0 kg (HR: 0.63; 0.55-0.73), class I obese had 27% lower rates (HR: 0.73; 0.64-0.85) and class II obese had 16% lower rates (HR 0.84; 0.71-0.98). Middle-aged adults (40-59 years old) had 27% lower weight loss (HR 0.83; 0.73-0.94) compared to ≥60 year-olds. Females (HR: 0.90; 0.81-0.99), patients with higher health care utilization (HR 0.86; 0.75-0.99), and Stage 1 hypertension (HR: 0.87; 0.77-0.98) had lower weight loss rates. Socioeconomic and provider factors did not predict weight loss.
Conclusions: Among overweight and obese patients that achieved hypertension control, only 32% had ≥2.0 kg weight loss and 15% achieved ≥5.0 kg weight loss. Effective weight loss interventions are needed to maintain hypertension control and decrease target organ damage in this population.
Author Disclosures: H.M. Johnson: None. C.M. Bartels: None. C.T. Thorpe: None. N. Pandhi: None. E.A. Jacobs: None. M.A. Smith: None.
- © 2014 by American Heart Association, Inc.