Cardiovascular Changes After Weight Reduction in Obesity Hypertension

Reisin, Efrain; Fröhlich, Edward D.; Messerli, Franz H.; Dreslinski, Gerald R.; Dunn, Francis G.; Jones, M.M.; Batson, Hugh M.

doi:10.7326/0003-4819-98-3-315

Cited by 240 publications

(63 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[51][52][53] Thus, it can be suggested that these factors may have contributed towards decreased antihypertensive drug use after loss of excessive weight due to the bariatric surgery.…”

Section: Antihypertensive Drugsmentioning

confidence: 99%

Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

View full text Add to dashboard Cite

CONTEXT AND OBJECTIVE: Bariatric surgery has been an effective alternative treatment for morbid obesity and has resulted in decreased mortality, better control over comorbidities and reduced use of drugs. The objective of this study was to analyze the impact of bariatric surgery on medication drug and nutritional supplement use. DESIGN AND SETTING: Longitudinal study of before-and-after type, on 69 morbidly obese patients in a public hospital in Porto Alegre. METHODS: Through interviews, the presence of comorbidities and use of drugs with and without prescription were evaluated. RESULTS: Among the 69 patients interviewed, 85.5% had comorbidities in the preoperative period, with an average of 2.3 (± 1.5) per patient. The main comorbidities reported were hypertension, diabetes and dyslipidemia. 84.1% of the patients were using prescribed drugs in the preoperative period. The mean drug use per patient was 4.8, which decreased to 4.4 after the procedure. The surgery enabled significant reduction in use of most antidiabetic (84%), antilipemic (77%) and antihypertensive drugs (49.5%). On the other hand, there was a significant increase in use of multivitamins and drugs for disorders of the gastrointestinal tract. The dosages of most of the drugs that continued to be prescribed after surgery were decreased, but not significantly. CONCLUSION: After bariatric surgery, there were increases in the use of vitamins, gastric antisecretory drugs and antianemic drugs. Nevertheless, there was an overall reduction in drug use during this period, caused by suspension of drugs or dose reduction. RESUMO CONTEXTO E OBJETIVO:A cirurgia bariátrica tem sido uma alternativa efetiva de tratamento para a obesidade mórbida, resultando na diminuição da mortalidade, melhor controle das comorbidades e redução no uso de medicamentos. O objetivo deste estudo foi analisar o impacto da cirurgia bariátrica sobre a utilização de medicamentos e suplementos nutricionais. TIPO DE ESTUDO E LOCAL: Estudo longitudinal do tipo antes e depois com 69 pacientes obesos mórbi-dos em um hospital público de Porto Alegre. MÉTODOS: Nas entrevistas, foram avaliados a presença de comorbidades e o uso de medicamentos com e sem prescrição médica. RESULTADOS: De 69 pacientes entrevistados, 85,5% apresentaram comorbidades no período pré-cirúrgi-co, média de 2,3 (± 1,5) por paciente. As principais comorbidades relatadas foram hipertensão, diabetes e dislipidemias. 84,1% dos pacientes estavam em uso de medicamentos sob prescrição médica, no período pré-cirúrgico. A média de uso de medicamentos por paciente foi de 4,8, reduzindo para 4,4 após o procedimento. A cirurgia proporcionou diminuição significativa do uso da maioria dos antidiabéticos (84%), antilipêmicos (77%) e anti-hipertensivos (49,5%). Por outro lado, observou-se aumento significativo na utilização de multivitamínicos e medicamentos para desordens do trato gastrointestinal. A maior parte dos medicamentos que continuaram sendo prescritos após a cirurgia teve sua dose reduzida, no entanto, esta redução nã...

show abstract

“…[51][52][53] Thus, it can be suggested that these factors may have contributed towards decreased antihypertensive drug use after loss of excessive weight due to the bariatric surgery.…”

Section: Antihypertensive Drugsmentioning

confidence: 99%

Medication and nutritional supplement use before and after bariatric surgery

Backes

Lopes²,

Tetelbom

et al. 2016

Sao Paulo Med. J.

View full text Add to dashboard Cite

show abstract

“…Therefore, it is possible that the target organ for augmented sympathetic activity in obesity might be the kidney rather than the blood vessels. The observations that obesity is associated with volume overload and decreased peripheral resistance [Messerli, 1982], which are partly reversed by weight loss [Reisin et al, 1983], lend some support to this alternative hypothesis. Nevertheless, the present study does not provide evidence supporting this possibility because plasma renin activity was not different in obese and lean subjects and did not change after weight loss.…”

Section: Weight Lossmentioning

confidence: 59%

Sympathetic Vascular Tone in Human Obesity

Agapitov

Sinkey

Dopp

et al. 2004

Journal of Hypertension

View full text Add to dashboard Cite

Obesity is associated with increased sympathoactivation that elevates arterial pressure. However, the mechanism linking sympathetic activation to arterial pressure is unclear. Specifically, it has never been demonstrated unequivocally that sympathetically mediated vasoconstriction is increased in obesity. This project tested the hypothesis that sympathetic vascular tone is increased in obese normotensive and hypertensive subjects.The effect of weight loss on sympathetic vascular tone was also assessed.Sympathetic vascular tone was assessed as forearm vasodilatation to intra-arterial phentolamine (α 1/2 -adrenergic receptor antagonist). Pharmacological responses were correlated with skeletal muscle sympathetic nerve activity (mSNA). Obese subjects with and without hypertension had increased mSNA. However, the vasodilatator response to phentolamine was not augmented in obese normotensive and hypertensive subjects versus lean controls. Additionally, weight loss did not alter phentolamine's vasodilatator response, despite reducing mSNA and arterial pressure in obese groups. These results indicate that sympathetic vascular tone is not increased in obesity despite higher mSNA.These studies also assessed forearm resistance vessel function using intra-arterial nitroprusside (nitric oxide donor) and isoproterenol (β 2 -adrenergic receptor agonist). The effects of weight loss on these responses were studied in the obese groups. The response to both vasodilators was blunted, but only in obese hypertensive subjects. Weight loss normalized the response to nitroprusside but not to isoproterenol. This result suggests that obesity-related hypertension is associated with vascular smooth muscle dysfunction, which can be improved by weight loss. Blunted vasodilatation to isoproterenol suggests an abnormality on β 2 -adrenergic receptor-dependent mechanisms that may or may not depend on the endothelium. Also, mental stress-induced forearm vasodilatation was blunted in obese normotensive subjects, which was not normalized by weight loss. 2In conclusion, increased sympathetic nerve activity does not augment forearm sympathetic vascular tone. This dissociation could be due to opposing local factors (e.g. insulin, leptin) or to a different target of limb sympathoactivation (e.g. adipocytes vs. vascular). Sympathetic drive to tissues other than the peripheral circulation may play a more important role in arterial pressure elevation in obesity, either directly or indirectly.Abstract Approved: ____________________________________ Thesis Supervisor ____________________________________

show abstract

“…Il semblerait que ce soit une relation de cause à effet, en ce sens qu'une diminution du poids entraînerait du même coup une baisse de la pression sanguine (Reisin et al, 1983). Les personnes obèses dont la masse adipeuse se concentre dans le haut du corps sont plus susceptibles d'en souffrir, la pression exercée dans la région du coeur étant plus grande (Watanabe et Tochikubo, 2003).…”

Section: Hypertension Artérielleunclassified

Analyse génotypique de gènes de susceptibilité à l'obésité au sein d'une cohorte de travailleurs forestiers de la compagnie Abitibi Consolotidated de Saint-Félicien /

Tremblay¹

2004

View full text Add to dashboard Cite

Cardiovascular Changes After Weight Reduction in Obesity Hypertension

Cited by 240 publications

References 30 publications

Medication and nutritional supplement use before and after bariatric surgery

Medication and nutritional supplement use before and after bariatric surgery

Sympathetic Vascular Tone in Human Obesity

Analyse génotypique de gènes de susceptibilité à l'obésité au sein d'une cohorte de travailleurs forestiers de la compagnie Abitibi Consolotidated de Saint-Félicien /

Contact Info

Product

Resources

About