1st Department of General and Endocrine Surgery, Medical University of Bialystok, Białystok, Poland
1st Department of General and Endocrine Surgery, Medical University of Bialystok, Białystok, Poland.
Pol Arch Intern Med. 2021 Aug 30;131(7-8):693-700. doi: 10.20452/pamw.16023. Epub 2021 Jun 2.
Obesity‑related hypertension is a life threatening medical condition that significantly increases the risk of cardiovascular diseases and premature mortality. Effective treatment of obesity may be achieved by laparoscopic sleeve gastrectomy (LSG). This surgical method contributes not only to sustained weight loss but also to normalization of blood pressure.
To evaluate the effect of weight loss after LSG on partial or full control of blood pressure.
A retrospective analysis of medical and clinical data of 305 patients who had undergone LSG was performed. The bariatric effect of LSG was assessed by calculating percentage of total weight loss (%TWL), percentage of excess weight loss (%EWL), and percentage of excess BMI loss (%EBMIL). Blood pressure status after surgery was categorized as partial or full hypertension resolution.
A total of 143 patients (46.9%) were diagnosed with hypertension preoperatively with median (IQR) hypertension duration of 7.52 (1.88-13.16) years. Hypertensive patients were older (49 vs 38.5 years) and had higher prevalence of coexisting diseases (type 2 diabetes, dyslipidemia, and obstructive sleep apnea) than patients with normal blood pressure. During 1‑year follow up, 90 patients (63%) used lower doses of antihypertensive medications and 33 patients (23%) discontinued the therapy. Twelve months after the surgery, median (IQR) %TWL in the control group was 32.5% (28.1%-37.7%), while in the hypertensive group, 29.1% (25.9%-33.6%) (P <0.001); %EWL was 62.9% (53%-74.6%) and 54.8% (47.4%-68.2%), respectively (P = 0.001), and %EBMIL 73.9% (59.5%-91.2%) and 63% (55%-80.5%), respectively (P = 0.002).
Laparoscopic sleeve gastrectomy is an effective method for the treatment of obesity‑ related hypertension. However, weight loss induced by LSG does not affect the blood pressure status after the surgery.
肥胖相关高血压是一种危及生命的医疗状况，会显著增加心血管疾病和过早死亡的风险。腹腔镜袖状胃切除术（LSG）可有效治疗肥胖症。这种手术方法不仅有助于持续减肥，还能使血压正常化。
评估 LSG 后体重减轻对部分或完全控制血压的效果。
对 305 例接受 LSG 的患者的医学和临床数据进行回顾性分析。通过计算总体重减轻百分比（%TWL）、超重减轻百分比（%EWL）和超重 BMI 减轻百分比（%EBMIL）来评估 LSG 的减肥效果。术后血压状况分为部分或完全高血压缓解。
共有 143 例患者（46.9%）术前诊断为高血压，中位（IQR）高血压病程为 7.52（1.88-13.16）年。高血压患者年龄较大（49 岁比 38.5 岁），并存疾病（2 型糖尿病、血脂异常和阻塞性睡眠呼吸暂停）的患病率更高。在 1 年随访期间，90 例患者（63%）使用了较低剂量的降压药物，33 例患者（23%）停止了治疗。术后 12 个月，对照组的中位（IQR）%TWL 为 32.5%（28.1%-37.7%），而高血压组为 29.1%（25.9%-33.6%）（P<0.001）；%EWL 分别为 62.9%（53%-74.6%）和 54.8%（47.4%-68.2%）（P=0.001），%EBMIL 分别为 73.9%（59.5%-91.2%）和 63%（55%-80.5%）（P=0.002）。
腹腔镜袖状胃切除术是治疗肥胖相关高血压的有效方法。然而，LSG 引起的体重减轻并不能影响手术后的血压状况。
