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65岁以上患者减重手术后高血压完全缓解的预测因素——一项多中心研究

Predictors of complete remission of hypertension in patients over 65 years of age after bariatric surgery - a multicenter study.

作者信息

Dowgiałło-Gornowicz Natalia, Jaworski Paweł, Walędziak Maciej, Lech Pawel, Kucharska Alicja, Major Piotr

机构信息

Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury, Olsztyn, Poland.

Department of General, Oncological and Digestive Tract Surgery, Centre of Postgraduate Medical Education, Orłowski Hospital, Warsaw, Poland.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2024 Mar;19(1):76-82. doi: 10.5114/wiitm.2024.135997. Epub 2024 Mar 4.

Abstract

INTRODUCTION

In the era of an aging society and a growing number of obese people, an increasing number of older patients are consulting bariatric surgeons. The incidence of hypertension (HT) also rises with age and body weight, making the treatment of the elderly a significant challenge.

AIM

To identify predictors of HT remission after bariatric surgery in patients over 65 years of age.

MATERIAL AND METHODS

A retrospective study analyzed patients over 65 years old with HT who underwent laparoscopic bariatric procedures in Poland between 2008 and 2022. The data came from 11 bariatric centers. Patients were categorized into two groups: responders (R) and non-responders (NR). A multivariate logistic regression analysis was conducted to identify significant independent risk factors.

RESULTS

The study analyzed 244 patients, with complete HT remission observed in 55 (22.5%) patients. Almost 90% of patients showed improvement in HT. The mean follow-up time was 47.4 months. Factors contributing to HT remission included HT duration of less than 5 years, the use of single medication, and a significant correlation with %EWL.

CONCLUSIONS

Bariatric surgery in patients aged over 65 has a positive effect on HT remission. The chance of HT remission increases with fewer medications, shorter HT duration, and greater weight loss after surgery.

摘要

引言

在社会老龄化和肥胖人群不断增加的时代,越来越多的老年患者咨询减重外科医生。高血压(HT)的发病率也随着年龄和体重的增加而上升,这使得老年患者的治疗成为一项重大挑战。

目的

确定65岁以上患者减重手术后HT缓解的预测因素。

材料与方法

一项回顾性研究分析了2008年至2022年期间在波兰接受腹腔镜减重手术的65岁以上HT患者。数据来自11个减重中心。患者分为两组:缓解者(R)和未缓解者(NR)。进行多因素逻辑回归分析以确定显著的独立危险因素。

结果

该研究分析了244例患者,其中55例(22.5%)患者的HT完全缓解。近90%的患者HT有所改善。平均随访时间为47.4个月。导致HT缓解的因素包括HT病程小于5年、使用单一药物以及与%EWL显著相关。

结论

65岁以上患者的减重手术对HT缓解有积极作用。药物使用减少、HT病程缩短以及术后体重减轻更多会增加HT缓解的机会。

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