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腹腔外科手术对高血压结果的影响:回顾性队列研究
Jesse E Passman1,2, Amanda Bader3, Nadim Mahmud4
1Department of Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. jesse.passman@pennmedicine.upenn.edu.
Journal of human hypertension
|August 20, 2025
概括
代谢和减肥手术 (MBS) 在患有高血压的肥胖患者中显著改善了血压控制. 与医疗管理相比,MBS导致血压降低,药物需求减少,抗性高血压风险降低.
科学领域:
- 心脏病学 心脏病学
- 代谢手术 代谢手术
- 高血压管理 高血压管理
背景情况:
- 代谢和减肥手术 (MBS) 是对肥胖和代谢综合征的公认治疗方法.
- 关于MBS对高血压结果的影响的长期数据很少.
- 高血压是肥胖个体常见的并发症.
研究的目的:
- 为了比较MBS治疗的肥胖和高血压患者与医疗管理之间的血压 (BP) 控制.
- 评估MBS对抗高血压药物 (AHM) 使用,明显耐治疗高血压 (ATRH) 发展和高血压缓解的影响.
- 在一个大队伍中评估MBS对高血压的长期结果.
主要方法:
- 在退伍军人卫生管理局 (2000-2019) 进行的回顾性队列研究.
- 纳入标准:成人BMI≥35kg/m2和新的高血压诊断.
- 统计分析包括概括估计方程和时间更新的考克斯模型,具有治疗权重的逆概率.
主要成果:
- 在5.1年的中位数随访期间,183,702名患者接受了医疗管理,3965人接受了MBS.
- 经过手术治疗的患者表现出显著降低的静脉血压 (平均5.4毫米升) 和静脉血压 (平均1.8毫米升).
- MBS与停止AHM的可能性增加32%,发展ATRH的可能性降低14%.
结论:
- 代谢和减肥手术为肥胖和高血压患者的血压控制提供了持久的改善.
- MBS与降低抗高血压药物负担和明显抗治疗高血压的发病率较低有关.
- 这些发现支持MBS作为一种有价值的治疗选择,用于在严重肥胖的情况下管理高血压.
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