Blood pressure, weight, and cholesterol: A report of the Program on the Surgical Control of the Hyperlipidemias (POSCH)

Objective: To examine the blood pressure (BP), weight, and cholesterol data from the Program on the Surgical Control of the Hyperlipidemias (POSCH). Blood pressure (BP) reductions have been attributed to extra-lipid effects of statin drugs. In POSCH, no statin drugs were used and marked lipid reduction was achieved by partial ileal bypass operation. Methods: Plasma total and low-density lipoprotein (LDL) cholesterol, BP, and body weight (as body mass index [BMI]) in POSCH patients at baseline and at 5-years after randomization were compared. Results: There were no statistically significant differences in mean systolic or diastolic BP between the control and intervention groups at baseline. At 5 years, however, statistically significant (P <0.0005) differences in mean systolic and diastolic BP were found between the groups. Similarly, the differences between the groups in BMI and plasma total and LDL-cholesterol were not statistically significant at baseline, but were at 5 years (P <0.0001). By multivariate regression analyses, consistent, statistically significantly relationships were found between BMI and BP (P <0.0001). In addition, for systolic BP, in the entire POSCH population (n = 838), a statistically significant relationship was found on regression analysis for the plasma total cholesterol (P <0.013). Conclusion: POSCH is the only major lipid/atherosclerosis trial to establish a relationship between cholesterol reduction and BP reduction without the need to implicate statin drugs' extra-lipid effects.