Hypertension:减重手术可降低顽固性高血压患病率

2019-02-05 国际循环编辑部 国际循环

减重手术是降低血压(BP)的有效策略,但大多数证据依赖于诊室血压测量。Carlos A. Schiavon等研究者开展的这项研究,评估减重手术对24 h血压曲线、血压变异度和顽固性性高血压患病率的影响。

减重手术是降低血压(BP)的有效策略,但大多数证据依赖于诊室血压测量。Carlos A. Schiavon等研究者开展的这项研究,评估减重手术对24 h血压曲线、血压变异度和顽固性性高血压患病率的影响。

Hypertension发表的GATEWAY随机临床试验,纳入1级和2级肥胖患者,其使用至少2种最大剂量抗高血压药物,或使用> 2种中等剂量药物。患者被分配到腹腔镜Roux-en-Y旁路手术(RYGB)联合药物治疗或单独药物治疗12个月。主要结局是24 h血压曲线和变异性(白天和夜间血压的平均实际变异性)。顽固性高血压的非浸润状态和患病率评估作为次要终点。

最终入选100例患者(女性占76%,体重指数为36.9±2.7 kg/m2)。 12个月后24 h血压曲线(包括非浸润状态)相似,但与单独药物治疗相比,RYGB组抗高血压等级较低[0 (0~1)vs. 3(2.5~4)级;P<0.01]。与药物治疗相比,RYGB后收缩期夜间血压的平均实际变异性较低(组间差异为-1.63; 95%CI:-2.91~-0.36;P=0.01)。基线时顽固性高血压的患病率相似(RYGB 10% vs. 药物治疗,16%;P=0.38),但在12个月时RYGB组显著降低(0% vs. 14.9%;P<0.001)。

总之,RYGB显著降低抗高血压药物种类,然而, 两组24 h血压曲线(含非浸润状态)相似。有趣的是,减重手术可改善血压变异性,并可减轻与肥胖相关的顽固性高血压负担。



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    2019-10-17 feather89
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    2019-02-07 xinmeili
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    2019-02-05 lietome2

    好文,值得点赞!认真学习了,把经验应用于实践,为患者解除病痛。

    0

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