title: [Prevalence and subtypes of systemic hypertension in an unselected patient population with severe obesity undergoing bariatric surgery].
abstract: BACKGROUND
  Obesity plays a pivotal role in the development of systemic hypertension and the two diseases are often related. Severe obesity is getting more and more prevalent in our country. The aim of this study was to evaluate the prevalence of systemic hypertension in an unselected population of obese patients observed in the Regional Referral Center for Surgical Obesity of our hospital.
  
  
  METHODS
  233 consecutive patients (52 male, 181 female, mean age 42 years, mean weight 120 kg, mean body mass index [BMI] 43.7 kg/m2) were screened in order to plan a surgical procedure for severe obesity. Each patient underwent cardiovascular clinical evaluation, ECG and echocardiographic examination, blood pressure ambulatory monitoring, and 24h Holter monitoring.
  
  
  RESULTS
  Thirty-five percent of patients were under drug treatment for hypertension or were at least aware of being hypertensive; among the remaining 65% of patients who declared having normal blood pressure, 33% suffered from systemic hypertension, 11% had isolated clinical hypertension, and 14% had masked hypertension. Thus, the global prevalence of systemic hypertension in this population raised to 72.5%. ECG and echocardiographic findings were normal in about 90% of the whole population, whereas 24h Holter monitoring showed minor or major abnormalities in approximately 25% of patients. At a follow-up of at least 18 months, a subgroup of 48 patients showed a decrease in body weight from 129 to 92 kg, BMI from 47 to 33 kg/m 2, blood pressure from 134.4/86.4 to 127.7/81.1 mmHg, and heart rate from 79.7 to 69.4 bpm.
  
  
  CONCLUSIONS
  The prevalence of systemic hypertension in an unselected population of severely obese patients is much higher than in the general population. The surgical procedures performed in the Regional Referral Center for Surgical Obesity of our hospital were virtually free from serious adverse events and proved to be effective in reducing not only body weight and BMI but also blood pressure. We believe that ambulatory blood pressure and 24h Holter monitoring are the most relevant examinations to be performed in these patients in the preoperative period.
authors.affiliation: Cardiologia San Luca, Dipartimento del Cuore e dei Vasi. montereggi@interfree.it
authors.forename: Alessio
authors.initials: A
authors.lastname: Montereggi
authors.forename: Alessandra
authors.initials: A
authors.lastname: Leone
authors.forename: Gabriele
authors.initials: G
authors.lastname: Castelli
authors.forename: Lucia
authors.initials: L
authors.lastname: Bracci
authors.forename: Katia
authors.initials: K
authors.lastname: Baldini
authors.forename: Katalin
authors.initials: K
authors.lastname: Virag
authors.forename: Carmelo
authors.initials: C
authors.lastname: Guido
authors.forename: Carlo Maria
authors.initials: CM
authors.lastname: Rotella
authors.forename: Marcello
authors.initials: M
authors.lastname: Lucchese
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D050110:Bariatric Surgery; D018660:Blood Pressure Monitoring, Ambulatory; D015992:Body Mass Index; D001835:Body Weight; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D057234:Preoperative Period; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000959:Antihypertensive Agents