Does Losing Weight Lower Blood Pressure? A Doctor of Obesity Medicine Responds

Managing high blood pressure can be an intricate and delicate balancing act, where every lifestyle choice plays a crucial role in maintaining a healthy equilibrium. Embracing natural strategies, like limiting alcohol and getting regular exercise, can make a significant difference. These healthy choices may also lead to shedding a few pounds, which can be a particularly impactful option for controlling high blood pressure. “When people lose weight, they are relieving a lot of extra stress on the body,” explains Meghan Garcia-Webb, MD, who is triple-board-certified in internal medicine, lifestyle medicine, and obesity medicine.

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According to the Mayo Clinic, even modest weight loss can have significant benefits. Generally, for every kilogram (about 2.2 pounds) you lose, your blood pressure can drop by about one millimeter of mercury (mm Hg).

Dr. Garcia-Webb emphasizes the evidence that weight reduction can lead to lower blood pressure: “It may be the hormonal changes that matter the most, and we can observe this in bariatric studies, where the hormonal changes and initial blood pressure drop can happen prior to the subsequent weight loss.”

Continue reading to uncover the intricate links between blood pressure and weight loss, explore whether some weight loss strategies are more effective than others and learn whether weight loss can help you reduce or eliminate your blood pressure medication.

How losing weight can reverse high blood pressure

First, let’s understand why there’s a connection between weight and blood pressure. Dr. Garcia-Webb explains that extra weight can lead to high blood pressure in several key ways:

• Inflammatory proteins: Excess fat releases inflammatory signaling proteins that can damage the lining of blood vessels, making them stiffer and more susceptible to injury.

• Kidney function: The additional fat increases salt and water retention by the kidneys. This excess fluid places greater strain on the heart and blood vessels.

• Hormonal impact: Increased body weight results in higher levels of hormones like insulin and leptin. As mentioned, these hormones affect kidney function and activate the sympathetic nervous system, constricting blood vessels further.

• Reduction in adiponectin: Excess fat decreases adiponectin levels, a beneficial protein that reduces inflammation in the blood vessels and helps prevent high blood pressure.

The culmination of these processes is increased bodily fluids and stiffening of blood vessels, which are more prone to damage—creating a harmful cycle that escalates blood pressure. Dr. Garcia-Webb points out that when you lose weight through healthy lifestyle adjustments, medications, surgery, or a combination of these approaches, it’s natural to see your blood pressure improve, too. This, in turn, can lower your risk of a slew of cardiovascular diseases, including:

• Heart attacks

• Heart failure

• Aortic aneurysms

• Peripheral vascular disease

• Strokes

• Sudden cardiac death

Losing weight also reduces your risk of sleep apnea, which often goes unnoticed but can seriously impact your health. Sleep apnea happens when your breathing stops and starts repeatedly during sleep, straining your heart and often leading to high blood pressure.

How much weight loss can lower blood pressure?

“In general, the greater the weight loss, the greater the reduction in blood pressure. But even weight loss of 5 to 10% can reduce blood pressure,” shares Dr. Garcia-Webb.

Additionally, you should expect improvements in your cholesterol levels. Losing weight helps reduce body fat and lowers the likelihood of inflammation.

Will weight loss allow me to stop taking blood pressure medication?

“It is not at all uncommon for patients that lose weight to decrease their blood pressure medications or even stop them altogether. Not everyone can do this, but losing weight can greatly improve your chances,” explains Dr. Garcia-Webb.

It’s important to never adjust your blood pressure medication on your own. Always consult with your healthcare provider before making any changes.

Are there specific weight loss strategies that are more effective in reducing blood pressure?

“Lifestyle strategies are the cornerstone of reducing blood pressure—lowering salt and alcohol intake are key,” says Dr. Garcia-Webb. She also points out that a vegetarian diet can be quite beneficial for managing blood pressure. Dr. Garcia-Webb adds that exercise “is very important for weight maintenance, and it also helps our blood vessels stay healthy.”

For those looking to ease back into physical activity, Lee MacDonald, MD, a cardiologist with AdventHealth in Littleton, CO, recommends walking. “I usually advise my patients to walk for 30 minutes five days per week. This can be broken into two 15-minute walks each day.” He also supports incorporating weight or resistance training, noting that doing so two to three times per week “has been demonstrated to improve cardiovascular health and particularly blood pressure.”

Dr. Garcia-Webb further notes that while lifestyle changes are essential, FDA-approved weight loss medications often lead to more significant weight loss than lifestyle changes alone. Additionally, bariatric surgery tends to result in the most substantial weight reductions, achieving the greatest blood pressure reductions.

What to consider about weight loss and blood pressure

While some weight loss medications are effective, they may have unintended effects on blood pressure. Stimulants such as phentermine and bupropion, found in the weight loss medication Contrave, may not be suitable for patients with uncontrolled blood pressure. “Anyone on these medications should make sure they are getting their blood pressure assessed regularly to ensure it stays at a healthy level,” she emphasizes.

She also advises caution regarding diets that are heavy in meats and fats. Although such diets might boost satiety and prompt short-term weight loss, the high levels of salt and saturated fats they often contain can lead to long-term problems, including elevated cholesterol and blood pressure.

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