Reduced antihypertensive treatment with maintained ambulatory blood pressure control following weight loss in type 2 diabetes

Background In individuals with type 2 diabetes and hypertension, weight loss may reduce antihypertensive treatment needs, but effects on blood pressure variability and nocturnal dipping are unclear. We investigated changes in antihypertensive treatment and ambulatory blood pressure following a weight-loss intervention in adults with overweight and type 2 diabetes.Methods This single-arm intervention trial included 32 participants with type 2 diabetes undergoing a dietary weight-loss intervention. Antihypertensive medications were discontinued at intervention start and reintroduced if blood pressure increased. Changes in antihypertensive treatment, ambulatory blood pressure, and office blood pressure were assessed from baseline to 12 months.Results Mean (SD) age was 61 ± 6 years and baseline weight 102 ± 16 kg. Mean weight loss at 12 months was 11.6 ± 6.0 kg. The median number of antihypertensive medications decreased from 2 to 1 (p = 0.004), and antihypertensive treatment use from 88% to 59%. Office and ambulatory blood pressure, including nocturnal dipping, remained largely unchanged. Daytime and nighttime heart rate, and nighttime systolic blood pressure variability decreased (all p < 0.05).Conclusions In adults with overweight and type 2 diabetes, office and ambulatory blood pressure remained stable after weight loss, despite a reduction in antihypertensive treatment.Trial registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT05491005