The implication for practicing physicians who see moderately overweight people with high blood pressure is that their first goal should be weight reduction, he said.
"Only after six months of trying to reduce the patient's weight can a decision be made about drug treatment," Fogari said.
Dr. Daniel W. Jones, dean of the University of Mississippi School of Medicine, and a spokesman for the American Heart Association, said the study finding "is not new news, but it is important news."
There have been a number of previous studies showing that weight loss can reduce blood pressure, Jones said. "But this is an increasingly important problem in societies around the world," he said. "Once you gain weight, you find it difficult to lose weight, which is why we focus so much on preventing obesity these days."
As for drug treatment of high blood pressure, about half of California adults diagnosed with hypertension do not take medication for it, another report presented at the same meeting found.
The study of 11,467 persons given a diagnosis of hypertension found that 49.4 percent were not taking drugs to reduce their blood pressure, said the report by researchers at the California Department of Public Health's Heart Disease and Stroke Prevention Program.
There were some bright spots in the picture. Compliance was more than five times higher for those who had seen a doctor in the past year than for those who had not. And the compliance rate was twice as high for persons with health insurance than the uninsured.
For more on high blood pressure and what to do about it, turn to the American Heart Association.
SOURCES: Roberto Fogari, M.D., professor of medicine, University of Pavia, Italy; Daniel W. Jones, M.D., head, Univers
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