Universidad Científica del Sur, Lima, Peru.
Universidad Científica del Sur, Lima, Peru.
Int J Surg. 2022 Aug;104:106716. doi: 10.1016/j.ijsu.2022.106716. Epub 2022 Jun 19.
Nowadays, the high morbimortality of obesity is mainly related to diabetes, cancer, and hypertension. It is reported that obesity in patients with hypertension can lead to resistance to pressure reduction through pharmacological therapy and lifestyle changes, so bariatric surgery emerges as a proposed treatment for obesity.
We performed an umbrella review that included systematic reviews of clinical trials that evaluated patients with hypertension and non-morbid obesity. The quality and certainty of the evidence was evaluated with the AMSTAR-II and GRADE tools.
677 systematic reviews were identified, of which only three were included for analysis. We considered the outcomes addressed by the reviews on hypertension, identifying that 5 RCTs evaluated pressure reduction at 1 year of follow-up and 5 RCTs at more than 1 year, 5 RCTs evaluated hypertension rate, 6 RCTs analyzed changes in systolic pressure and 5 RCTs changes in diastolic pressure. Likewise, when assessing the methodological quality, it was concluded that the three reviews have critically low quality.
We found only three systematic reviews that evaluated the topic with critically low methodological quality. They reported results in favor of metabolic surgery, but with very low certainty of evidence.
如今，肥胖的高发病率和死亡率主要与糖尿病、癌症和高血压有关。据报道，高血压患者的肥胖会导致对药物治疗和生活方式改变的降压反应产生抵抗，因此减重手术作为肥胖的一种治疗方法应运而生。
我们进行了伞式综述，其中包括评估高血压和非病态肥胖患者的临床试验的系统评价。使用 AMSTAR-II 和 GRADE 工具评估证据的质量和确定性。
共确定了 677 项系统评价，其中只有 3 项被纳入分析。我们考虑了综述中关于高血压的结果，发现 5 项 RCT 评估了 1 年随访时的降压效果，5 项 RCT 评估了超过 1 年的降压效果，5 项 RCT 评估了高血压发生率，6 项 RCT 分析了收缩压的变化，5 项 RCT 分析了舒张压的变化。同样，在评估方法学质量时，得出的结论是这 3 项综述的质量具有批判性地低。
我们只发现了 3 项系统性综述，这些综述的方法学质量具有批判性地低。它们报告了代谢手术有利的结果，但证据的确定性非常低。
