Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, Weston, Florida.
Surg Obes Relat Dis. 2019 Jun;15(6):920-925. doi: 10.1016/j.soard.2019.03.008. Epub 2019 Mar 22.
Morbid obesity is strongly associated with hypertension.
The objective of this study is to compare the risk of developing hypertension before and after bariatric surgery.
U.S. university hospital.
We retrospectively reviewed all patients who underwent bariatric surgery from 2010 to 2015 at our institution. Nonhypertensive white individuals without diabetes at baseline were included in our study. The Framingham Hypertension Risk Score was used to predict the near-term incidence of the disease. This calculator predicts 1-, 2-, and 4-year incidence of hypertension.
A total of 475 patients met the criteria for the hypertension risk score calculation. Females composed 72% (n = 342) of our population with a mean age of 42.6 ± 11.6 years. Laparoscopic sleeve gastrectomy was the most prevalent procedure at 81.89% (n = 389). At 12- month follow-up, the 1-year absolute risk reduction (ARR) and the relative risk reduction (RRR) were 6.2% and 69.2% (P < .01), respectively. The 2-year ARR was 11.9%, with an RRR of 67.9% (P < .01). The 4-year risk was also calculated at 12-month follow-up, resulting in an ARR of 20.1%, and RRR of 63.7% (P < .01). Furthermore, stratifying by type of procedure, the results were comparable between sleeve gastrectomy and Roux-en-Y gastric bypass. Regarding blood pressure values at 12-month follow-up, the systolic blood pressure was reduced 11.4 mm Hg (P < .01) and the diastolic blood pressure was reduced 4.4 mm Hg (P = .07). The percentage of estimated body mass index loss at 12-month follow-up was 71.7%.
Sleeve gastrectomy and Roux-en-Y gastric bypass significantly diminish the risk of developing hypertension in morbidly obese patients. Prospective studies are needed to better comprehend these findings.
病态肥胖与高血压密切相关。
本研究旨在比较减重手术后高血压发生的风险。
美国大学医院。
我们回顾性分析了 2010 年至 2015 年在我院接受减重手术的所有患者。将基线时无糖尿病的非高血压白种人纳入本研究。使用弗雷明汉高血压风险评分预测疾病的近期发病率。该计算器预测高血压 1 年、2 年和 4 年的发病率。
共有 475 例患者符合高血压风险评分计算标准。女性占 72%（n=342），平均年龄为 42.6±11.6 岁。腹腔镜袖状胃切除术最常见，占 81.89%（n=389）。在 12 个月的随访中，1 年绝对风险降低（ARR）和相对风险降低（RRR）分别为 6.2%和 69.2%（P<.01）。2 年 ARR 为 11.9%，RRR 为 67.9%（P<.01）。在 12 个月的随访中还计算了 4 年的风险，结果显示 ARR 为 20.1%，RRR 为 63.7%（P<.01）。此外，按手术类型分层，袖状胃切除术和 Roux-en-Y 胃旁路术之间的结果相似。关于 12 个月随访时的血压值，收缩压降低 11.4mmHg（P<.01），舒张压降低 4.4mmHg（P=.07）。12 个月随访时估计体重指数丢失率为 71.7%。
袖状胃切除术和 Roux-en-Y 胃旁路术显著降低病态肥胖患者发生高血压的风险。需要前瞻性研究来更好地理解这些发现。
