O.I. Mitchenko, A.S. Lavrik, А.O. Shkroba, V.Yu. RomanovEffect of medical and surgical treatment of obesity on cardiovascular risk in patients with arterial hypertension and morbid obesity

The aim – to study dynamics of cardiovascular risk in patients with arterial hypertension and morbid obesity before and 6 months after conservative and surgical treatment of obesity.
Material and methods. We examined 164 patients with morbid obesity (BMI > 40 kg/m2), they formed two groups. The first group included 81 patients who treated obesity with diet and drug Stifimol. The second group included 83 patients who underwent bariatric surgery (gastric banding or gastric bypass surgery). Patients were examined before and 6 months after treatment of obesity. All patients underwent clinical examination, determination of anthropometric parameters, indicators of carbohydrate and lipid metabolism, measurement of office SBP and DBP, ambulatory blood pressure monitoring and cardiac ultrasound study. Cardiovascular risk was defined by scales SCORE, SCOREHDL, SCOREBMI, PROCAM, DRS, Framingham.
Results. 6 months after treatment, in both groups significant decrease of weight and BMI was registered. Body weight decreased by 5,5 kg (4.6 %) in the 1st group and by 35 kg (22.8 %) in the 2nd group. Greater reduction in body weight after bariatric surgery was associated with significant reduction of cardiovascular risk (reducing the number of patients at very high risk by average 23 % by scales SCORE, SCOREHDL, SSOREBMI, by 15 % using PROCAM scale and by 43 % using FRAMINGHAM scale) and lowering risk of diabetes by scale DRS (by 13 %) compared to patients under drug treatment.
Conclusions. Weight loss after bariatric surgeries contributes to normalization of office SBP, DBP, BP profile, reduces left ventricular hypertrophy, has positive effect upon lipid, carbohydrate metabolism and decreases cardiovascular risk.

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