Supplementary Material for: Intentional Weight Loss and Dose Reductions of Antihypertensive Medications: A Retrospective Cohort Study

<b><i>Background:</i></b> Though it is well known that weight loss tends to decrease blood pressure, the quantitative association between the magnitude of weight loss and the effect on the need for antihypertensive medications is not well studied. We analyzed this association among overweight and obese attendees at two outpatient weight management centers. <b><i>Methods:</i></b> Case records of patients with a body mass index &gt;25 at baseline were analyzed. The weight loss intervention consisted of a calorie-restricted diet (~1,000 kcal/day deficit), a behavior modification plan, and a plan for increasing physical activity. <b><i>Results:</i></b> The study cohort consisted of 100 participants, and the mean follow-up period was 15 ± 3.5 months. Significant weight loss (12.2 ± 3.4 kg) and systolic/diastolic blood pressure reductions (9.1/6.3 mm Hg) were observed by study exit. For 5, 10, and 15% weight loss, respectively, 3, 39, and 39% of the patients achieved at least 1 discontinuation of any antihypertensive medication, and 8, 42, and 21 dose reductions were achieved. Dose reductions or discontinuations occurred in all classes of antihypertensive medications with similar magnitudes of weight loss. <b><i>Conclusions:</i></b> Intentional weight loss can potentially result in dose reductions/discontinuations of antihypertensive medications. Our results should be validated with data from larger randomized controlled studies and may help to inform the conduct of a systematic review of prior randomized controlled trials that contain data on medication changes accompanying weight loss.

**背景**：尽管减重可降低血压已是学界共识，但减重幅度与降压药物（antihypertensive medications）需求变化之间的定量关联尚未得到充分研究。本研究针对两家门诊体重管理中心的超重及肥胖就诊者，对该关联展开了分析。
**方法**：本研究分析了基线期体重指数（body mass index, BMI）＞25的患者的病例档案。减重干预方案包括热量限制饮食（每日热量缺口约1000千卡）、行为矫正计划以及增加体力活动的方案。
**结果**：本研究队列共纳入100名参与者，平均随访时长为15±3.5个月。至研究结束时，受试者实现了显著减重（12.2±3.4 kg），收缩压/舒张压（systolic/diastolic blood pressure）亦分别下降9.1/6.3毫米汞柱（mm Hg）。按减重幅度5%、10%、15%分组，分别有3%、39%、39%的患者实现了至少1种降压药物的停用，且分别实现了8例、42例、21例的药物剂量下调。在各类降压药物中，均观察到与相似减重幅度对应的剂量下调或停药情况。
**结论**：有计划的减重可实现降压药物的剂量下调或停用。本研究结果需通过更大样本量的随机对照试验数据进行验证，其结果或可为开展针对既往含减重伴随药物变化数据的随机对照试验的系统综述提供参考。