hypertension
Central and peripheral hemodynamics in patients with essential hypertension on a fasting diet
Klin Med (Mosk). 2003;81(9):35-9.
[Article in Russian]
Murav'ev SA, Malishevskii MV, Makarova GA, Andreeva OV.
Effectiveness of an antihypertensive action of fasting therapy was studied in 147 patients with arterial hypertension stage I-II. Estimation of systolic and diastolic functions of the left ventricle in patients with arterial hypertension was carried out using stress echocardiography with isometric loading. Dynamics of systolic and diastolic arterial pressure (AP) and changes in the hyperbaric index for diastolic AP were assessed at 24-h AP monitoring. The course of fasting therapy consisting of a 2-week fasting period and the recovery period of the same duration resulted in a statistically significant reduction of weight, a decrease of average daily systolic and diastolic AP, lowering of the hyperbaric index of diastolic AP and improvement of the diastolic reserve of the left ventricle. 24-h AP monitoring and stress echocardiography within 3 months showed a high clinical effectiveness of fasting therapy.
Medically supervised water-only fasting in the treatment of hypertension.
J Manipulative Physiol Ther. 2001 Jun;24(5):335-9.
Goldhamer A, Lisle D, Parpia B, Anderson SV, Campbell TC.
Center for Conservative Therapy, Penngrove, Calif, USA.
BACKGROUND: Hypertension-related diseases are the leading cause of morbidity and mortality in industrially developed societies. Although antihypertensive drugs are extensively used, dietary and lifestyle modifications also are effective in the treatment of patients with hypertension. One such lifestyle intervention is the use of medically supervised, water-only fasting as a safe and effective means of normalizing blood pressure and initiating health-promoting behavioral changes. METHODS: One hundred seventy-four consecutive hypertensive patients with blood pressure in excess of 140 mm Hg systolic, 90 mm Hg diastolic (140/90 mm Hg), or both were treated in an inpatient setting under medical supervision. The treatment program consisted of a short prefasting period (approximately 2 to 3 days on average) during which food consumption was limited to fruits and vegetables, followed by medically supervised water-only fasting (approximately 10 to 11 days on average) and a refeeding period (approximately 6 to 7 days on average) introducing a low-fat, low-sodium, vegan diet. RESULTS: Almost 90% of the subjects achieved blood pressure less than 140/90 mm Hg by the end of the treatment program. The average reduction in blood pressure was 37/13 mm Hg, with the greatest decrease being observed for subjects with the most severe hypertension. Patients with stage 3 hypertension (those with systolic blood pressure greater than 180 mg Hg, diastolic blood pressure greater than 110 mg Hg, or both) had an average reduction of 60/17 mm Hg at the conclusion of treatment. All of the subjects who were taking antihypertensive medication at entry (6.3% of the total sample) successfully discontinued the use of medication. CONCLUSION: Medically supervised water-only fasting appears to be a safe and effective means of normalizing blood pressure and may assist in motivating health-promoting diet and lifestyle changes.
Weight loss with very-low-calorie diet and cardiovascular risk factors in moderately obese women: one-year follow-up study including ambulatory blood pressure monitoring.
Int J Obes Relat Metab Disord 1998 Jul;22(7):661-6
Pekkarinen T; Takala I; Mustajoki P. Department of Medicine, Helsinki University Hospital, Finland.
The beneficial effects of weight loss with a very-low-calorie diet (VLCD) on cardiovascular risk factors have been reported at the end of energy restriction. As the effects, especially on blood pressure, may not remain constant during weight maintenance, we studied the longer-term effects of weight loss on 24h ambulatory blood pressure (ABP), lipids, glucose and insulin. DESIGN: Prospective study of a 17-week weight loss programme containing an eight-week VLCD period and follow-up visit at one-year. SUBJECTS: Twenty-nine moderately obese, normotensive or mildly hypertensive women. The mean +/- s.d. body mass index (BMI) was 36.0 +/- 2.6 kg/m2 and mean age 40.3 +/- 8.3 y. RESULTS: In the last week of the VLCD, the mean (s.d.) weight loss was 12.4 +/- 3.3 kg (P < 0.001), at the end of the programme 15.1 +/- 4.4 kg (P < 0.001 vs baseline), and at one-year follow-up 10.7 +/- 7.6 kg (P < 0.001 vs baseline). Mean 24 h ABP decreased 8.0/4.6 mmHg (P < 0.001 for both) on the last week of the VLCD, at the end of the programme, the systolic ABP decrease was 4.7 mmHg (P < 0.01 vs baseline) and diastolic 2.1 mmHg (not statistically significant (NS) vs baseline). At one-year follow-up, the mean systolic ABP decrease was 4.1 mmHg (P < 0.01 vs baseline) and mean diastolic 3.0 mmHg (P < 0.05 vs baseline). Sodium excretion decreased 55 mmol/24 h in the last VLCD week (P < 0.01) and returned to baseline after that. At the one-year follow-up, beneficial changes, compared with baseline, were observed in mean serum glucose (-0.28 mmol/l, P < 0.05), triglyceride (-0.35 mmol/l, P < 0.01) and HDL cholesterol (+0.16 mmol/l, P < 0.001). CONCLUSIONS: This weight loss programme with a VLCD enabled obese subjects to lose weight and decrease cardiovascular risks. Despite some regain in weight during follow-up, the beneficial effects were overall maintained over the year. Sodium intake tended to increase during follow-up. Information on sodium restriction should be included in weight loss programmes.
Obesity and arterial hypertension: II Effect of a reducing diet and fasting.
Krotkiewski M, Ruzyllo E, Kotowska A.
Polish Medical Science and History 1967; 10: 58-62
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