Dias Carina Vieira, Silva Ana Lúcia, Dias Joana, Cardoso Paulo, Castanheira Rute, Fernandes Andreia, Nunes Filipa, Sanai Tina, Sanchez Mercedes, Maia-Teixeira João, De Sousa-Coelho Ana Luísa
Escola Superior de Saúde, Universidade do Algarve (ESSUAlg), 8005-139 Faro, Portugal.
Insight: Piaget Research Center for Ecological Human Development, Instituto Piaget, Av. João Paulo II, 1950-157 Lisboa, Portugal.
Clin Pract. 2025 Jan 2;15(1):11. doi: 10.3390/clinpract15010011.
BACKGROUND/OBJECTIVES: Obesity remains a global health concern and is associated with increased risk of type 2 diabetes, hypertension, and cardiovascular disease overall. Dissimilar hypertension guidelines are available for clinicians, namely those prepared by the American Heart Association (AHA) and the European Society of Cardiology (ESC), which may lead to distinctive appreciation of health outcomes of patients with obesity after bariatric and metabolic surgery, such as hypertension remission. The main goal of this study was to compare the effects of applying stricter (AHA) versus looser (ESC) blood pressure criteria on hypertension diagnosis pre-bariatric surgery and remission assessment one year post-op.
A retrospective analysis of clinical data from patients who underwent surgical treatment for obesity at a single university hospital was performed. To evaluate the hypertension improvement or remission, two different types of blood pressure (BP) categorization were considered (based on AHA and ESC guidelines), in which each patient would fit according to their BP values pre- (m0) and 12 months postoperative (m12).
From a sample of 153 patients submitted for surgical treatment of obesity, more patients were considered with hypertension based on the AHA guideline (130 vs. 102; < 0.001), while a higher rate of hypertension remission at 12 months after bariatric surgery was observed when following the ESC guideline (58.82 vs. 53.08%). Baseline patients' clinical characteristics based on each hypertension outcome were mostly independent of the guideline used ( > 0.05), where only age and systolic blood pressure were relatively higher in "ESC groups".
We conclude that only minor differences exist between the two guidelines used. If evaluated based on ESC guidelines, it is expected that less patients are considered with hypertension, and the remission rate may be, at least numerically, higher.
背景/目的：肥胖仍然是一个全球健康问题，总体上与2型糖尿病、高血压和心血管疾病风险增加相关。临床医生可获得不同的高血压指南，即美国心脏协会（AHA）和欧洲心脏病学会（ESC）制定的指南，这可能导致对肥胖患者在减肥和代谢手术后的健康结果有不同的认识，如高血压缓解情况。本研究的主要目的是比较采用更严格（AHA）与更宽松（ESC）的血压标准对减肥手术前高血压诊断及术后一年缓解评估的影响。
对在一家大学医院接受肥胖手术治疗的患者的临床资料进行回顾性分析。为评估高血压的改善或缓解情况，考虑了两种不同类型的血压（BP）分类（基于AHA和ESC指南），每位患者将根据其术前（m0）和术后12个月（m12）的血压值进行分类。
在153例接受肥胖手术治疗的患者样本中，根据AHA指南，被认定患有高血压的患者更多（130例对102例；<0.001），而遵循ESC指南时，减肥手术后12个月高血压缓解率更高（58.82%对53.08%）。基于每种高血压结果的基线患者临床特征大多与所使用的指南无关（>0.05），只有年龄和收缩压在“ESC组”中相对较高。
我们得出结论，所使用的两种指南之间仅存在微小差异。如果根据ESC指南进行评估，预计被认定患有高血压的患者会更少，并且缓解率可能至少在数值上更高。
