Department of Preventive Medicine and Public Health, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain.
Department of Mathematics, Statistics and Operations Research, University of La Laguna, 38200 Santa Cruz de Tenerife, Spain.
Int J Environ Res Public Health. 2022 Jan 29;19(3):1575. doi: 10.3390/ijerph19031575.
Arterial hypertension (HTN) is common among morbidly obese patients undergoing bariatric surgery. The aim of this study is to analyse the prevalence and evolution of HTN and weight loss in patients suffering from morbid obesity before and after bariatric surgery, during a follow-up period of five years.
A before-and-after study was carried out on severely obese patients undergoing Laparoscopic Roux-En-Y Gastric Bypass (LRYGB). Criteria for HTN diagnosis were current treatment with antihypertensive agents and/or systolic blood pressure (SBP) > 140 mmHg and/or diastolic (DBP) > 90 mmHg. HTN remission was defined as normalisation of blood pressure (BP) maintained after discontinuation of medical treatment, and HTN recurrence was considered when HTN diagnostic criteria reappeared after remission. Weight loss during the study period was evaluated for each patient, calculating excess weight loss percentage (% EWL) and BMI loss percentage (% BMIL) with reference to the baseline value.
A total of 273 patients were included in the study. HTN was present in 48.2%; 29.4% of hypertensive patients showed HTN remission two years after the surgical procedure, 30.3% of them had relapsed at five years.
LRYGB in obese patients is associated with a remission of HTN, and no weight loss differences were observed between the group of patients showing HTN remission at two years and the group who did not. However, differences were observed after the second follow-up year, with an increased weight loss in the remission group, which could indicate that sustained weight loss favours the control of HTN.
动脉高血压（HTN）在接受减重手术的病态肥胖患者中很常见。本研究旨在分析病态肥胖患者在接受减重手术后五年的随访期间 HTN 和体重减轻的发生率和演变。
对接受腹腔镜 Roux-en-Y 胃旁路术（LRYGB）的严重肥胖患者进行了前后对照研究。HTN 的诊断标准为目前使用抗高血压药物和/或收缩压（SBP）>140mmHg 和/或舒张压（DBP）>90mmHg。HTN 缓解定义为停止药物治疗后血压正常化，缓解后再次出现 HTN 诊断标准时则认为 HTN 复发。评估每位患者在研究期间的体重减轻情况，计算体重减轻百分比（%EWL）和 BMI 减轻百分比（%BMIL），参考基线值。
共有 273 例患者纳入研究。HTN 发生率为 48.2%；29.4%的高血压患者在手术两年后出现 HTN 缓解，其中 30.3%在五年后复发。
肥胖患者接受 LRYGB 与 HTN 缓解相关，在两年时出现 HTN 缓解的患者组和未缓解的患者组之间未观察到体重减轻的差异。然而，在第二个随访年后观察到差异，缓解组的体重减轻增加，这可能表明持续的体重减轻有利于 HTN 的控制。
