International Medical Journal, Vol. 24., Iss. 4, 2018, P. 5−10.
EFFECT OF ANTIHYPERTENSIVE THERAPY AND BARIATRIC SURGERY ON ARTERIAL STIFFNESS IN PATIENTS WITH ARTERIAL HYPERTENSION AND MORBID OBESITY
State Institution "Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine", Dnipro, Ukraine
In order to establish the features of the dynamics of the elastic properties of the arterial wall in patients with arterial hypertension and morbid obesity under the influence of antihypertensive therapy depending on the presence of bariatric obesity, a study was conducted that included 56 patients with obesity I−III degree and uncontrolled hypertension. The design of the study consisted of four stages. Office systolic and diastolic blood pressure and the elastic−elastic properties of the arterial wall RT, AIx ao, AIx br, DRA, SAI and DAI were measured using an Arteriograph oscillometric instrument (Tensiomed, Hungary). The dynamics of changes in the elastic properties of the arterial wall in patients with arterial hypertension and morbid obesity under the influence of long−term antihypertensive therapy was studied depending on the bariatric surgical treatment. The features of the influence of surgical treatment of obesity on the course of arterial hypertension and the characteristics of vascular stiffness are determined. It was established that, despite the achievement of target blood pressure numbers in both groups, it was after surgical treatment of obesity that the level of systolic and diastolic blood pressure was significantly lower. By the end of the study, the achievement of normal performance of all the characteristics of elastic−elastic properties was established. However, at the 4th visit, the pulse wave velocity was 17.94 % lower in the bariatric surgery group, and the RT level was 30.16 % higher than in the control group. An increase in the mass fraction of the diastole phase was also observed in accordance with the DAI value in the main group and the absence of statistically significant changes in this indicator after 6 months in the control group. At the same time, AIx ao significantly decreased only in the group of exclusively drug treatment and at the time of completion of the semi−annual observation it decreased by 19.23 %.
Key words: arterial hypertension, blood pressure, morbid obesity, body mass index, bariatric surgery, arterial stiffness, pulse wave velocity, augmentation index, antihypertensive therapy.