Abstract P374: 24-h Blood Pressure Profile, Non-dipping Status And Incidence Of Resistant Hypertension In Patients Randomized To Bariatric Surgery Versus Medical Therapy: The Gateway Randomized Trial

Autor:	Celso Amodeo, Marcio G. de Souza, Ricardo Cohen, Frederico L.J. Monteiro, Lucas P. Damiani, Angela Cristine Bersch-Ferreira, Camila Ragne Torreglosa, Carlos A. Schiavon, Patricia Malvina Noujaim, Otavio Berwanger, Eliana Vieira Santucci, Helio Halpern, Juliana D Oliveira, Tamiris A Miranda, Silvana de Barros, Dimas Ikeoka, Alexandre Biasi Cavalcanti, Luciano F. Drager, Luiz Bortolloto, Renato Hideo Nakagawa Santos
Rok vydání:	2018
Předmět:	medicine.medical_specialty business.industry Incidence (epidemiology) Resistant hypertension medicine.disease Obesity law.invention Surgery Blood pressure Randomized controlled trial law Internal Medicine Medicine In patient business Medical therapy
Zdroj:	Hypertension. 72
ISSN:	1524-4563 0194-911X
DOI:	10.1161/hyp.72.suppl_1.p374
Popis:	Background: Bariatric surgery represents an effective strategy for office blood pressure (BP) reduction in obese hypertensive patients. However, no previous study evaluated the impact of bariatric surgery on 24-h BP profile, non-dipping status and incidence of resistant hypertension (RH). Methods: This is a sub-analysis of a randomized clinical trial including hypertensive patients with grade 1 and 2 obesity, aged 18 to 65 years, using at least 2 drugs at optimal doses or >2 at moderate doses. Patients were randomly allocated to either Roux-en-Y Gastric Bypass (RYGB) with medical therapy (MT) or MT alone for 12 months. We analyzed the 24-h BP profile, non-dipping status (defined by Results: A total of 100 patients were included (76% female, age 43.8±9.2 years, BMI 36.9±2.7 Kg/m 2 ). The 24-h BP profile was similar at 12 months in both groups, but the RYGB group required less anti-hypertensive classes compared to the MT alone (Figure). The rate of non-dipping BP did not change significantly during the follow-up (RYGB: from 18/48 (37.5%) to 22/48 (45.8%); p=0.30; MT: from 16/33 (48.5%) to 15/33 (45.5%); p=0.80). In an exploratory analysis, the incidence of RH was similar at the baseline (RYGB 10% (5/50) and MT 16% (8/50); p=0.38). After 12 months, it changed significantly in the RYGB group: 0% (0/49) while remained stable in the MT group: 14.9% (7/47) (p Conclusions: RYGB significantly reduced anti-hypertensive medications while promoting similar 24-h BP profile and non-dipping BP status compared to the MT alone. RYGB may be an attractive strategy to reduce RH incidence in obese patients.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::f1ed398a2e1d34e1baf0eae15d4cbaf0 https://doi.org/10.1161/hyp.72.suppl_1.p374 Zobrazit plný text záznamu