Antihypertensive Medication Use Trajectories After Bariatric Surgery: A Matched Cohort Study.

Autor:	Passman JE; Department of Surgery (J.E.P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia., Wall-Wieler E; Global Health Economics & Outcomes Research Division, Intuitive, Sunnyvale, CA (E.W.-W., Y.L., F.Z.).; Department of Community Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg, Canada (E.W.-W.)., Liu Y; Global Health Economics & Outcomes Research Division, Intuitive, Sunnyvale, CA (E.W.-W., Y.L., F.Z.)., Zheng F; Global Health Economics & Outcomes Research Division, Intuitive, Sunnyvale, CA (E.W.-W., Y.L., F.Z.).; Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX (F.Z.)., Cohen JB; Renal-Electrolyte and Hypertension Division, Department of Medicine (J.B.C.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.; Department of Biostatistics, Epidemiology, and Informatics (J.B.C.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Jazyk:	angličtina
Zdroj:	Hypertension (Dallas, Tex. : 1979) [Hypertension] 2024 Aug; Vol. 81 (8), pp. 1737-1746. Date of Electronic Publication: 2024 Jun 04.
DOI:	10.1161/HYPERTENSIONAHA.124.23054
Abstrakt:	Background: Metabolic and bariatric surgery (MBS) is the most effective and durable treatment for obesity. We aimed to compare the trajectories of antihypertensive medication (AHM) use among obese individuals treated and not treated with MBS. Methods: Adults with a body mass index of ≥35 kg/m 2 were identified in the Merative Database (US employer-based claims database). Individuals treated with versus without MBS were matched 1:1 using baseline demographic and clinical characteristics as well as AHM utilization. Monthly AHM use was examined in the 3 years after the index date using generalized estimating equations. Subanalyses investigated rates of AHM discontinuation, AHM initiation, and apparent treatment-resistant hypertension. Results: The primary cohort included 43 206 adults who underwent MBS matched with 43 206 who did not. Compared with no MBS, those treated with MBS had sustained, markedly lower rates of AHM use (31% versus 15% at 12 months; 32% versus 17% at 36 months). Among patients on AHM at baseline, 42% of patients treated with MBS versus 7% treated medically discontinued AHM use ( P <0.01). The risk of apparent treatment-resistant hypertension was 3.41× higher (95% CI, 2.91-4.01; P <0.01) 2 years after the index date in patients who did not undergo MBS. Among those without hypertension treated with MBS versus no MBS, 7% versus 21% required AHM at 2 years. Conclusions: MBS is associated with lower rates of AHM use, higher rates of AHM discontinuation, and lower rates of AHM initiation among patients not taking AHM. These findings suggest that MBS is both an effective treatment and a preventative measure for hypertension. Competing Interests: E. Wall-Wieler, Y. Liu, and F. Zheng are employed by Intuitive. The other authors report no conflicts.
Databáze:	MEDLINE
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