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. Author manuscript; available in PMC: 2014 Jan 27.
Published in final edited form as: Hypertens Res. 2011 Nov 3;35(1):4–16. doi: 10.1038/hr.2011.173

Table 1.

Selected controlled clinical trials of weight loss interventions and their effect on BP

Subjects
(active/control)		 Duration
(months)		 Daily
dose (mg)		 Weight,
Δ (%)		 Placebo-adjusted
weight Δ (%)		 SBP Δ
(mmHg)		 Placebo-adjusted
SBP Δ (mmHg)		 SBP Δ per 5%
weight loss (mm Hg)
Lifestyle
  Neter et al.130 4874 6 NA −5.8 −4.4 −3.8
  DPP: intensive150 1079/1082 38 NA −5.9 −5.8 −3.3 −2.7 −2.3
  LOOK AHEAD136 2570/2575 48 NA −4.7 −3.6 −4.6 −1.3 −1.8
Restrictive surgery
  Sjöström et al.137 156/627 120 NA −13.2 −14.8 +2.1 −2.3 −0.8
  O’Brien et al.151 40/40 24 NA −21.6 −16.1 − 14.2 −4.8 −1.5
Malabsorptive surgery
  Hofso et al.152 76/63 12 NA −30 −22.0 −14.0 −4.0 −0.9
  Sjöström et al.137 34/627 120 NA −25 −26.6 −4.7 −6.8 −1.3
Sibutramine
  SCOUT138 4906/4898 41 10 −1.8 −1.8 +1.4 +2.0
  Erondu et al.153 100/101a 6 10 −6.0 −4.2 +2.1 +2.0 +2.4
Phentermine
  OB301154 326a 6 15 −5.8 −4.3 −3.3 −1.7 −2.0
  Kang et al.155 74 3 30 −9.3 −7.4 −1.0 +2.0 +1.3
Diethylpropion
  Cercato et al.156 37/32 6 12 −9.8 −6.6 −4.4 +2.7 +2.1
Bupropion
  Anderson et al.157 105/112 6 400 − 10.1 −5.1 − 1.7 +0.9 +0.9
Orlistat
  Sjöström et al.158 343/340 12 360 −10.2 −4.1 −2.0 −3.0 −3.7
  XENDOS159 1640/1637 48 360 −5.3 −2.6 −4.9 −1.5 −2.9
  Miles et al.160 250/254 12 360 −4.6 −2.9 −2.1 −1.7 −2.9
  Erondu et al.153 99/101a 6 360 −4.8 −3.4 −1.4 −1.5 −2.2
GLP-1 agonists
  Liraglutide: Astrup et al.142 95/98 5 3 −7.4 −4.5 −6.9 −3.1 −3.4
  LEAD-6, liraglutide161 233 6 1.8 −3.5 −2.5 −3.6
  LEAD-6, exenatide161 231 6 0.02 −3.1 −2.0 −3.2
Topiramate
  Bray et al.162 50/48 6 192 −8.2 −4.6 −8.4 −6.7 −7.3*
  Wilding et al.133 215/215 12 192 −9.1 −7.4 −5.7 −6.1 −4.1
  Tonstad et al.163 53/56 6 192 −6.5 −4.6 −9.7 −4.8 −5.2*
  Stenlof et al.164 77/78 9 192 −9.1 −6.6 −7.6 −5.6 −4.2
  Toplak et al.143 105/100 6 192 −6.5 −4.8 −4.4 −4.0 −4.2
Zonisamide
  Gadde et al.165 20/17 8 427 −9.4 −7.6 −6.8 −5.4 −3.6
Pramlintide
  Aronne et al.147 36/25 6 360 −3.7 − 1.5 −4.5 −1.0 −3.3
Lorcaserin
  Smith RS et al.131 1538/1499 12 20 −5.8 −3.7 − 1.4 −0.6 −0.8
Metformin
  DPP: metformin150 1073/1082 38 1700 −2.2 −2.1 −0.3 +0.3 +0.7
Top+ Phen
  Gadde et al.134 981/979 12 92/15 −9.9 −8.5 −5.6 −3.2 −1.9
Bup+Nal
  Greenway et al.135 581/583 12 360/32 −6.1 −4.8 −0.1 +1.8 +1.9

Abbreviations: BP, blood pressure; Bup, bupropion; CI, confidence interval; DPP, diabetes prevention program; GLP-1, glucagon-like peptide-1; LEAD-6, liraglutide effect and action in diabetes; NA, not available; Nal, naltrexone; Phen, phentermine; SBP, systolic BP; XENDOS; Xenical in the Prevention of Diabetes in Obese Subjects.

The last column shows BP changes with weight loss adjusted for the degree of weight loss (to facilitate comparison of weight loss-independent effects on BP. The standard comparator for this parameter is derived from the first study listed (Netter et al.), a meta-analysis of lifestyle interventions lasting at least for 6 months). From this study, the calculated 95% confidence limits for change in SBP per 5% weight loss from lifestyle intervention are −2.5 to −5.1 mm Hg. BP reductions that are less than the lower 95% CI (that is, significantly less than that expected from degree of weight loss) are marked in italics. BP reductions that are more than the upper 95% CI (that is, significantly more than expected from the degree of weight loss) are marked in bold and with an.

*

Note that even longer-term lifestyle studies have an effect on BP that is less than would be predicted from short-term studies, even after controlling for less weight loss.

a

These trials had multiple active drugs. Subject numbers include only those randomized to placebo and the relevant drug.