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减重手术后 10 天和 6 个月时极度肥胖患者的 24 小时血压变异性降低与术前高血压有关。

Reduction of 24-h blood pressure variability in extreme obese patients 10 days and 6 months after bariatric surgery depending on pre-existing hypertension.

机构信息

Department of Internal Medicine and Gerontology, Jagiellonian University, Medical College, Krakow, Poland.

Department of Internal Medicine and Gerontology, Jagiellonian University, Medical College, Krakow, Poland.

出版信息

Eur J Intern Med. 2019 Feb;60:39-45. doi: 10.1016/j.ejim.2018.10.022. Epub 2018 Nov 9.

DOI:10.1016/j.ejim.2018.10.022
PMID:30420135
Abstract

UNLABELLED

Bariatric surgery is considered as a first line treatment in extreme obese patients to achieve a reduction in health risks. However, after surgical procedure obese patients with normal blood pressure (BP) levels still present residual risk, which may be partly related to lack of correction of BP profile and variability.

AIM

To evaluate short (10 days) and mid-term (6 months) changes of mean values, profile and variability of BP after bariatric surgery in extremely obese patients with and without hypertension.

MATERIALS & METHODS: A follow-up of cross-sectional study was conducted in 90 obese patients (aged 41.7 ± 11.3, BMI = 46.7 ± 5.7 kg/m2), who met the eligibility criteria and underwent bariatric surgery. Each patient underwent 24-h ambulatory BP monitoring with profile and variability estimation before, 10 days and 6 months after the intervention.

RESULTS

Sixty-seven (74.4%) patients had hypertension. Significant decrease from baseline in mean values of systolic and diastolic BP in 10 days (p < .005) and 6 months (p < .005) follow-up were observed only in patients with hypertension. Moreover, only hypertensive subjects revealed significant reduction (p < 0,05) from baseline in 24-h systolic and diastolic BP weighted standard deviation and average real variability after surgical procedure. No changes were found in dipping status.

CONCLUSIONS

Bariatric surgery not only decreased BP levels, but also contributed to reduction in BP variability in early period after intervention mainly in patients with pre-existing hypertension.

摘要

目的:评估极度肥胖患者在接受减重手术后短期(10 天)和中期(6 个月)的血压(BP)均值、特征和变异性的变化,这些患者有或无高血压。

材料与方法:这是一项随访的横断面研究,共纳入 90 名肥胖患者(年龄 41.7±11.3 岁,BMI=46.7±5.7kg/m2),这些患者符合入选标准并接受了减重手术。每位患者在术前、术后 10 天和 6 个月均接受 24 小时动态血压监测,以评估 BP 特征和变异性。

结果:67 名(74.4%)患者患有高血压。仅在高血压患者中观察到术后 10 天(p<.005)和 6 个月(p<.005)随访时收缩压和舒张压均值显著下降。仅高血压患者术后 24 小时收缩压和舒张压加权标准差和平均真实变异性显著降低(p<.05)。无昼夜节律变化。

结论:减重手术不仅降低了 BP 水平,而且还主要在术前患有高血压的患者中有助于降低术后早期的 BP 变异性。

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