International Medical Journal, Vol. 25., Iss. 2, 2019, P. 5−8.
EFFECT OF THERAPY ON PERIPHERAL HEMODYNAMIC PARAMETERS IN PATIENTS WITH ARTERIAL HYPERTENSION AND MORBID OBESITY AFTER BARIATRIC TREATMENT
State Institution "Dnipropetrovsk Medical Academy of Ministry of Health of Ukraine", Dnipro, Ukraine
The investigation was performed to evaluate the peculiarities of the dynamics of peripheral and central hemodynamic parameters in patients with arterial hypertension and obesity under the influence of antihypertensive therapy, depending on the presence of bariatric treatment of morbid obesity. The study included 56 patients with obesity and uncontrolled arterial hypertension (main group (36 individuals) with medications for arterial hypertension + surgical treatment for obesity; the control group (20 individuals) made only the patients with medication for arterial hypertension). The study design consisted of 4 stages. The value of the body mass index in main group was 47.30 (42.90; 56.10) kg/m2, in the control it did 33.80 (31.40; 36.80) kg/m2 and was reliably lower than in the main one (p < 0.05). The office peripheral and central systolic blood pressure, diastolic blood pressure, pulse arterial pressure and amplification blood pressure were measured with oscillometric arteriography using the Arteriograph device (Tensiomed, Hungary). The dynamics of changes in peripheral and central hemodynamic parameters in the patients with arterial hypertension and morbid obesity under the influence of prolonged antihypertensive therapy depending on the performed bariatric surgery has been studied. The peculiarities of the influence of bariatric treatment of obesity on the course of arterial hypertension and the level of peripheral and central arterial pressure have been determined. At the end of the 6−month follow−up period, all the patients achieved the target counts of "office" peripheral and central systolic as well as diastolic blood pressure. Only in the patients of main group we managed to normalize the level of peripheral pulse blood pressure. At the same time, immediately after bariatric surgery, in 6 months, the level of brachial systolic blood pressure and central diastolic blood pressure in the main group was significantly lower than that in the comparison group.
Key words: arterial hypertension, arterial pressure, morbid obesity, body mass index, bariatric surgery, antihypertensive therapy.