Cambios metabólicos de pacientes hipertensos provocados por perder peso

Título original : Short-term metabolic changes achieved by weight loss in hypertensive patients

Resumen :
Introducción: Glucose and lipid metabolism abnormalities of hypertensive patients are highly relevant due to its increase in cardiovascular risk; moreover, impaired fasting glucose (IFG) and impaired glucose tolerance (IGT) have a high risk of new-onset diabetes mellitus (DM) development. The objective of the study was to describe glucose metabolism abnormalities and the impact of mid-term weight loss.

Metodología: A six-month prospective, observational and multicentre study of patients with hypertension was conducted. Clinical antecedents, physical examination, blood test and treatments were collected in two separated visits; conventional advice was the only intervention planned.

Resultados: A total of 1957 patients were included, mean age 66.3 (10.9) years and 59.9% males. A previous diagnosis of glucose metabolism alteration was present in 43.9% (25.5% type-2 DM, 14.8% IFG, 1.6% IFG and IGT, 1.0% IGT and 1.0% type-1 DM). An increasing pattern of cardiovascular risk and target organ damage was observed according to the categories of fasting glucose. Oral glucose tolerance test (OGTT) was carried out in 234 patients (11.9%) patients and yielded the diagnosis of IGT in 44.7% or DM in 22.4% of patients with fasting glucose >100 mg/dl. Six months follow-up was achieved in 85.9% patients. A slight reduction in fasting glucose was observed in the whole cohort and patients who achieved >= 5% weight loss experienced the highest reduction in fasting glucose, LDL-c and triglycerides; moreover, 15.8% normalized their IFG.

Conclusiones : Glucose and lipid metabolism abnormalities are highly prevalent in hypertensive patients and improve with 5% of weight lost at 6 months follow-up. OGTT is not currently extended in daily clinical practise.

Autores : Cordero, A (Cordero, Alberto)1; Bertomeu-Martinez, V (Bertomeu-Martinez, Vicente); Mazon, P (Mazon, Pilar)2; Martin-Raymondi, D (Martin-Raymondi, Diego)3; Palma, JL (Luis Palma, Jose)4; Anguita, M (Anguita, Manuel)5; Lekuona, I (Lekuona, Inaki)6; Galve, E (Galve, Enrique)7; Gonzalez-Juanatey, JR (Gonzalez-Juanatey, Jose R.)2

Direcciones :
1. Hosp Univ San Juan, Dept Cardiol, Alicante 03550, Spain
2. Hosp Univ Santiago, La Coruna, Spain
3. Hosp Santos Reyes, Burgos, Spain
4. Hosp Ramon & Cajal, E-28034 Madrid, Spain
5. Hosp Reina Sofia, Cordoba, Spain
6. Hosp Galdakao, Bilbao, Spain
7. Hosp Valle De Hebron, Barcelona, Spain