Re: Aerobic Exercise Plus Hypocaloric Diet on Serum Leptin Concentrations in Adults With Primary Hypertension and Overweight/Obesity: Results From the EXERDIET-HTA Trial.

This correspondence addresses the EXERDIET-HTA substudy by Aparicio and colleagues, which concludes that 16 weeks of aerobic exercise plus a hypocaloric DASH diet reduced serum leptin more than diet with activity counselling in hypertensive adults with overweight or obesity. Five concerns are raised: inference from within-group p values despite a non-significant time × group interaction; pooling of three sub-threshold exercise protocols; mislabelling of an active comparator as 'attention control'; sevenfold attrition asymmetry analysed by complete-case rather than intention-to-treat methods; and effectively complete reversion of leptin at 6 months. A disaggregated, ITT re-analysis would yield more conservative but more defensible conclusions.