Most people discover they have high blood pressure at a visit to the doctor for some other health condition. It doesn’t usually make itself known, which is why about a quarter of Canadian adults have hypertension and a significant number don’t know they do. For those who are thinking of losing weight and improving their overall well being, the first step is to start counting calories, and the best way to start is to understand what are maintenance calories and then working with a calculator for maintenance calories to track your caloric intake.
For those who feel they want faster results or are unable to just lose weight working with a maintenance calories calculator, there are accredited weight loss services in Ontario, some even offering structured OHIP-covered weight loss programs, to help with weight loss using proven medications like Wegovy and Zepbound.
The link between weight loss, blood pressure and cholesterol is very simple to understand: Excess weight would make your heart work harder, and that would be reflected in the pressure of the cuff.
Why Extra Weight Affects Blood Pressure
Every minute of every day, your heart has to pump against more resistance, as it is forced to pump more blood through more tissue. That constant force has a cumulative effect over the years, making artery walls stiffer and more likely to be damaged.
There are also indirect ways that weight affects blood pressure. Obesity, especially in the abdomen, leads to low grade inflammation, insulin resistance, and disrupts the hormonal system involved in regulating sodium and fluid balance. Overnight hypertension is further increased by sleep apnea, which is much more common with weight gain.
That’s why weight management is part of hypertension management and not alongside.
Does Weight Loss Have An Effect On Blood Pressure?
Yes, for most individuals the effect is quite substantial. According to the literature and Hypertension Canada, it is about 1 mmHg drop in systolic blood pressure per kilogram of lost weight maintained.
If that person loses 10 kilograms and does not regain it, it’s a drop of 8-10 mmHg. This is similar to the effect of a single antihypertensive drug, and that’s why some patients might be able to decrease the dosage with their physicians’ guidance. No one should alter their BP medications without consulting their doctor, but that discussion can be had.
The individual’s results will depend on their age, genes, kidney function, existing medication and amount of visceral fat lost.
How Much Weight Loss To Lower Blood Pressure?
The number is typically less than what people think. The consensus of most clinical guidelines is that the percent of body weight at which cardiovascular indicators change significantly is between five and 10 percent.
At 220 pounds, that’s 11 to 22 pounds. At 180 pounds, it’s 9 to 18. Those numbers have significance because they are early. When a patient sets the 70 lb. loss target, their readings will typically begin to improve in the first 15, before they ever reach the target on the whiteboard.
What Else Improves Alongside The Reading?
Blood pressure is likely to cluster. The results are usually that LDL cholesterol and triglycerides decrease, HDL increases, fasting glucose and insulin sensitivity improve and the likelihood of advancing from prediabetes to type 2 diabetes decreases dramatically as weight is lost. Better sleep quality is associated with better airway clearance and improved sleep alone reduces blood pressure overnight. For each pound of weight loss, there is about a 4-lb loss of joint loading, making the activity side of the plan more sustainable.
These are the cardiovascular advantages of weight reduction that do not show up on a single chart line: Decreased arterial stress, much better blood circulation, and a decreased long-term risk of heart attack and stroke.
Calories Are One Variable, Not The Whole Equation
There’s more to weight control than eating. Cortisol (due to chronic stress, poor sleep, thyroid function, perimenopause and certain common medications such as some beta blockers, antidepressants and corticosteroids) all alter the baseline. Two persons who eat the same food may not end up at the same location.
This is why even a diet focused purely on reducing portions will stall at times, which is why an evaluation based on medications, bloodwork and sleep will almost always uncover something that the food diary missed.
Why Rapid Weight Loss Works Against The Goal
A very extreme diet is short term and doesn’t stick. Once the restriction is lifted, the weight comes back, and sometimes even more than was lost and in the form of fat.
It makes the blood pressure benefit go away, since the loss of weight is what matters, not losing weight once. The greater the number of times the weight has fluctuated, the poorer the cardiovascular outcomes. Here, a compromise position is not ‘gradual loss’. It is the version that will give a lasting effect.
Where Medical Support Changes The Outcome
Others achieve their goal by making changes in structure and habit. Others have attempted this over and over and failed, typically due to some biological blockage.
It can be done by ordering lab tests that will show up in your blood work, knowing if one of your medications is causing it or not, beginning treatment when it’s clinically deemed to be present, and changing it as your blood work changes. It does have real impact for those already taking blood pressure drugs; when weight loss occurs, anti-hypertensive treatment often has to be altered and patients can’t do this safely without supervision, since lowering blood pressure too quickly can cause serious consequences.
Where To Start
The BP change that is measurable is less than most people think and occurs before the goal weight is achieved. 5% is sufficient to make a difference.
If your reading has been rising and previous efforts have not been successful, the previous efforts were likely not effort. Have the underlying cause checked, and establish a first goal that is realistic and attainable, and then let the blood pressure fall along with the weight.
