LAUSR

Objective: To evaluate the effect of weight loss on vascular function and central hemodynamic parameters in obese individuals with different classifications of cardiovascular health according to the American Heart Association Design and method: Prospective intervention study with patients of both genders, aged 40 to 70 years and body mass index (BMI) > = 30 and < 40 kg/m2, instructed to follow a low-calorie diet (reduction of 800 kcal/day) for 8 weeks. They were submitted to clinical and nutritional assessment, analysis of central hemodynamic parameters using Mobil-O-Graphâ, and the endothelial function by post-occlusive reactive hyperemia using Laser Spectre Contrast Image. The patients (n = 71) were divided into two groups, iCVH (n = 31) and pCVH (n = 40). Results: The patients had a mean age of 51 years, 79% and 73% were female in iCVH and pCVH, respectively. After 8 weeks of nutritional intervention, there was a reduction in body mass index (iCVH, 34.2 ± 2.5 vs 32.9 ± 2.6 kg/m2, p< 0.001) (pCVH, 33.8 ± 2.8 vs 32.8 ± 2.7 kg/m2, p < 0.001), waist-height ratio (iCVH, 0.62 ± 0.05 vs 0.60 ± 0.01, p = 0.005) (pCVH, 0.62 ± 0.04 vs 0.60 ± 0.04, p = 0.001) and fat weight (iCVH, 36 ± 7 vs 32 ± 6 kg, p = 0.013) (pCVH, 35 ± 6 vs 33 ± 6 kg, p < 0.001). Compared to the baseline, peripheral systolic blood pressure (BP) (126 ± 14 vs 119 ± 15mmHg, p = 0.001), diastolic BP (80 ± 9 vs 76 ± 8mmHg, p = 0.004) and pulse pressure (46 ± 10 vs 42 ± 10mmHg, p = 0.025) was significantly decreased only in pCVH. In this group, central systolic pressure (117 ± 14 vs 112 ± 11mmHg, p = 0.014) was also decreased. Pulse wave velocity did not change in iCVH (7.2 ± 0.9 vs 7.2 ± 1.0m/s, p = 0.926) and was reduced in pCVH (7.5 ± 1.1vs7.2 ± 1.0m/s, p = 0.080), although not reaching statistical significance. In this same group, cutaneous vascular conductance in post-occlusive reactive hyperemia (1.07 ± 0.27 vs 1.17 ± 0.28, p = 0.003) increased compared to the baseline. Conclusions: In this sample of obese patients, the intervention with a low-calorie diet resulted in improvement of peripheral and central pressure and functional vascular parameters more evident in subjects with poor cardiovascular health.