Researchers in Italy found that about 50 percent of overweight, hypertensive adults, ranging in age from 29 to 65 years, achieved normal body weight and blood pressure after six months of treatment with a reduced-calorie diet.

This is important because it means that in these patients with elevated blood pressure who were overweight, the blood pressure was not a form of essential hypertension but was hypertension secondary to body weight, said Roberto Fogari, M.D., lead investigator of the study and professor of medicine at the University of Pavia, Italy.

These findings apply to western societies in general, but only to overweight patients, not to obese patients, with high blood pressure, Fogari said.

About one in three American adults has high blood pressure, which is defined as a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher. High blood pressure increases the risk for heart disease and stroke, the number. 1 and 3 causes of death in the United States.

The study analyzed 210 overweight men and women whose systolic blood pressure was more than 140 mmHg, but less than 159 mm Hg, and whose diastolic blood pressure was more than 90 mm Hg, but less than 99 mm Hg. The study patients, who had never been treated for high blood pressure, were overweight with a body mass index (BMI) 25 to 29.9 kg/m2. An individualized reduced-calorie diet was designed for each patient and reflected their specific food preferences.

The diet's main aim was to reduce calories to reduce the weight of each patient, Fogari said. About 50 percent of the patients also were treated with orlistat, a medication used with a low-calorie diet to help lose weight and maintain weight after losing pounds.

Orlistat is in a class of drugs called lipase inhibitors. It works in the intestines, where it blocks some of the fat eaten from being absorbed and digested. This undigested fat is then removed in bowel movements. Orlistat is often used with a low-calorie diet to achieve weight loss and maintain weight after weight loss in overweight patients who also may have high blood pressure, diabetes, high cholesterol or heart disease.

We gave orlistat only when diet alone was not able to achieve the appropriate reduction in body weight, Fogari said.

The dosages of orlistat varied from 120 milligrams (mg) to 360 mg daily and were individualized.

The aim of the study was to significantly reduce body weight by diet alone or diet plus orlistat and to evaluate the role that body weight loss had on blood pressure values.

After six months of dietary treatment, 49 percent of women and 53 percent of men achieved body weight reduction and normalization ” more than 5 percent weight loss, researchers said.

The study also found a mean reduction in systolic and diastolic blood pressure of about 5 percent.

Fogari emphasized the importance of initiating dietary advice and treatment in overweight patients with high blood pressure before beginning drug treatment.

The first step is to help the overweight patient lose weight, he said. Only after six months of trying to reduce the patient's weight can a decision be made about drug treatment. In the ongoing study, patients were evaluated at baseline, and after six and 12 months of treatment.

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For patients with symptoms, Cedars-Sinai Medical Center physicians have developed another low radiation approach they call low-dose coronary CTA as their routine. This results in a rather than a 9/10 reduction in radiation. In Brown's case, this was the test that was used, and, according to Berman, it may have saved her life. She was subsequently treated with a stent, a procedure used to keep coronary arteries expanded in patients with CAD and did not require coronary bypass surgery.

Berman notes: In symptomatic patients, a calcium score of even zero does not sufficiently rule out the possibility of having an obstructed coronary artery, which was the case here. Berman suggests that the coronary CTA may become the test of choice in symptomatic patients when the diagnosis is unclear.

My heart situation was somewhat of a hidden problem, and yet it could have been lights out' for me at any time. I feel like I dodged a bullet. It's just miraculous that the condition was found and correctly diagnosed through this imaging technique so that it could be treated quickly and correctly, says Brown.

Some major risk factors for coronary artery disease, other than an advanced age, include the following:

a family history of heart disease diabetes high blood pressure cigarette smoking or former cigarette smoking inactivity and obesity previous heart attack or mini stroke atypical symptoms, which women are more prone to

Heart attack is the leading cause of death for American women, and the American Heart Association has reported that half of all women will eventually die of heart-related diseases. Nearly twice as many women in the United States die of heart disease, stroke and other cardiovascular diseases as from all forms of cancer, including breast cancer.

The first in Southern California and one of only 10 hospitals in the state whose nurses have been honored with the prestigious Magnet designation, Cedars-Sinai Medical Center is one of the largest nonprofit academic medical centers in the Western United States. For 19 consecutive years, it has been named Los Angeles' most preferred hospital for all health needs in an independent survey of area residents. Cedars-Sinai is internationally renowned for its diagnostic and treatment capabilities as well as breakthroughs in biomedical research and superlative medical education. It ranks among the top 10 non-university hospitals in the nation for its research activities and is fully accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP).

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