Three-Year Outcomes of Bariatric Surgery in Patients With Obesity and Hypertension

著者: Carlos A. Schiavon, Deepak L. Bhatt, Dimas Ikeoka, Eliana Vieira Santucci, Renato Nakagawa Santos, Lucas Petri Damiani, Juliana Dantas de Oliveira, Rachel Helena Vieira Machado, Hélio Halpern, Frederico L.J. Monteiro, Patricia M. Noujaim, Ricardo V. Cohen, Márcio Gonçalves de Sousa, Celso Amodeo, Luiz Aparecido Bortolotto, Otávio Berwanger, Alexandre Biasi Cavalcanti, Luciano F. Drager - Annals of Internal Medicine 2020 被引用: 92

BACKGROUND: Midterm effects of bariatric surgery on patients with obesity and hypertension remain uncertain. OBJECTIVE: To determine the 3-year effects of Roux-en-Y gastric bypass (RYGB) on blood pressure (BP) compared with medical therapy (MT) alone. DESIGN: Randomized clinical trial. (ClinicalTrials.gov: NCT01784848). SETTING: Investigator-initiated study at Heart Hospital (HCor), São Paulo, Brazil. PARTICIPANTS: were randomly assigned (1:1 ratio). INTERVENTION: RYGB plus MT or MT alone. MEASUREMENTS: The primary outcome was at least a 30% reduction in total number of antihypertensive medications while maintaining BP less than 140/90 mm Hg. Key secondary outcomes were number of antihypertensive medications, hypertension remission, and BP control according to current guidelines (<130/80 mm Hg). RESULTS: and 2 patients required reoperation. LIMITATION: Single-center, nonblinded trial. CONCLUSION: RYGB is an effective strategy for midterm BP control and hypertension remission, with fewer medications required in patients with hypertension and obesity. PRIMARY FUNDING SOURCE: Ethicon, represented in Brazil by Johnson & Johnson do Brasil.