Obesity Prevention by Calorie Restraint Using the Bathroom Scale Model Prevents Hypertension for Life in Nonhuman Primates

Obesity prevention via application of the “bathroom scale” model of long term calorie restriction/calorie titration in nonhuman primates (NHPs) prevents the slow motion development of features of the metabolic syndrome, specifically dyslipidemia, and now hypertension. This has enabled time‐linked analysis of the natural history of emergent features in the search for mechanisms underlying the metabolic syndrome. The present study is a follow on of the first defining of normal NHP blood pressure (BP) (121.8 ± 1.6/63.5 ±1.1 mmHg systolic/diastolic respectively), with a Mean Arterial Pressure (MAP) of 85.6 ± 1.1 mmHg, as measured by the GE pro 100V2 instrument. We sought to determine the consequences of obesity, type 2 diabetes, and obesity prevention on the progression of hypertension. BP levels were found to be highly similar to those hypertension levels defined by the American Heart Association JNC7 report in humans, however, mean diastolic BP was significantly lower in NHPs relative to reported normal human levels. (63.5 vs ~ 80), albeit that the 80 is not the mean of normal but rather a threshold above which is abnormal, with mean of normal in humans undefined. We have found progressive increases in hypertension in NHPs with increasing body weight over the adult monkey range 7 to 25 kg (r=0.01, p=0.006). We also examined 1) the relationship of developing hypertension to T2DM onset/dx in 64 monkeys, 2) to the consequences of long‐term diabetes with and without obesity, and 3) then determined the relationship of diabetes prevention by calorie restriction (CR) to hypertension (N=7). Long term CR of NHPs for ~ 23+ years from early adulthood through old age entirely prevented all levels of hypertension compared to ad libitum fed controls (N=192), and in fact CR significantly lowered blood pressure levels (CR: SBP 116.5, DBP 58.2 & MAP 82.9 mm Hg; ad lib controls: SBP 131.3, DBP 66.6 & MAP 92.3 mm Hg). CR monkeys showed 11, 12 and 10% lower systolic, diastolic and mean arterial BPs respectively (p's<0.01). Elderly CR monkeys had a non‐significant difference in BP compared to the above referenced normal adults of similar weight with no CR. In addition systolic BP defined a greater prevalence of hypertension in adult NHPs (67%) compared to diastolic BP (21%) in adult rhesus monkeys. The life time prevalence of T2DM in nonhuman primates appears, based on current long term data, to be approximately 65%. Despite their similar prevalence, the overlap of diabetes and hypertension is not fully concordant, although both relate to obesity in NHPs. Non‐similar trajectories suggest separate underlying regulatory mechanisms. In conclusion, this large animal model naturally develops in middle age all features of human hypertension, including the high prevalence and wide range of severity, together with associations with obesity, age and diabetes. Support or Funding Information National Institute on Aging HHSN263200800022C