Reductions in blood pressure and medication costs with 100-pound weight loss.

Objective: Weight loss usually is accompanied by significant reductions in blood pressure for hypertensive obese individuals.

Method: We assessed changes in blood pressure, antihypertensive medications and cost for 72 patients who had lost more than 100 pounds in a medically supervised, behavioral, low-energy diet program (Health Management Resources™, HMR®). To assess changes in hypertensive medications we assigned scores for each medicine as follows: 4, maximum effective dose (MED); 3, 75% of MED; 2, 50% of MED; 1, 25% of MED; and 0, no medication; scores were summed for each patient. 54 patients (75%) were hypertensive; 31 were on antihypertensive medications. Medication costs were estimated as the Average Wholesale Price (AWP) from the June 2004 Red Book.

Results: Treated hypertensive patients were taking an average of 1.9 medications/patient (total of 58 medications), with an average medication score of 4.6 and an average monthly cost of $83. Weight loss of >100 pounds for all 72 patients was associated with a reduction of systolic (SBP) and diastolic (DBP) blood pressure of 11.6% (sem, 1.4) and 13.1% (sem, 1.4), respectively. Blood pressure for all 54 hypertensive patients decreased: SBP, 12.8% (sem, 1.7) and DBP, 14.8% (sem, 1.7). For 23 hypertensives not on medication blood pressures decreased: SBP, 9.9% (sem, 1.8) and DBP, 11.1 (sem, 2.0). All of these reductions were statistically significant (P<0.001). After weight loss only 16 of 31 patients were on antihypertensive medication (a total of 16 medications) and the average medication score decreased from 4.6 to .87 (P<0.001). The average medication cost decreased from $82 to $18/month (P<0.001) after weight loss, representing a 78% decrease in antihypertensive medication cost. Over a one-year period, these cost savings would amount to ~$781.

Conclusion: When morbidly obese individuals lost 100# systolic and diastolic blood pressure decreased 12–15%, antihypertensive medications decreased 72%, medication strength (score) decreased 81% and medication cost decreased 78%.