Weight loss surgery is still uncertain on the mid -term impact of patients with obesity and hypertension. In order to determine the three-year impact of ROUX-EN-Y stomach (Rygb) compared to the blood pressure (BP), the researchers performed a random clinical trial compared to the blood pressure (BP), and the results were published in the Ann Internal MED.
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Studies are included in patients with hypertension patients who receive at least 2 maximum dose drugs or 2 or more medium -dose drug treatment. The physical quality index (BMI) is between 30.0 and 39.9 kg/m2, 1: 1 random allocation accepts Rygb combined with MT or separate alone MT. The main result is that the total number of anti -hypertension drugs is reduced by at least 30%while maintaining blood pressure below 140/90mmHg. The main secondary result is the number of anti -hypertension drugs, the relief of hypertension, and the blood pressure control of the current guide (<130/80 mm Hg).
The results showed that among the 100 patients (76%are women; the average BMI, 36.9 kg/m2 [SD, 2.7]), 88%and 80%of the Rygb group completed the follow -up. Three years later, 73%of patients in the RYGB group had the main results, while 11%of patients in the MT group occurred (RR, 6.52 [95%Ci, 2.50-17.03]; P <0.001). Among the randomly distributed participants, 35%and 31%of the Rygb group, 2%and 0%in the MT group. In the absence of drug treatment, the blood pressure was less than 140/90mmHg and less than 130/80mmHg, respectively. The number of medications in the Rygb group and MT group within 3 years (quartermids) was 1 (0-2) and 3 (2.8-4) (P <0.001), respectively. The total weight loss of the RyGB group and MT group was 27.8%and -0.1%, respectively. In the Rygb group, 13 patients had low vitamin B12, and 2 patients needed re -surgery.
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In summary, the research results show that RyGB is an effective strategy for medium -term blood pressure control and high blood pressure relief. For patients with hypertension and obesity, there are fewer drugs required.
Carlos A Schiavon， et al.， Three-Year Outcomes of Bariatric Surgery in Patients With Obesity and Hypertension ： A Randomized Clinical Trial. Ann Intern Med. 2020 Nov 3;173(9)：685-693. doi： 10.7326/M19- 3781.