Revista da Sociedade Portuguesa de Endocrinologia Diabetes e Metabolismo

Online first

Revista Portuguesa de Endocrinologia, Diabetes e Metabolismo - Online first: 2020-10-05
Original article

Blood pressure and lipid profiles improvement in patients with obesity after lifestyle intervention-induced weight loss

Barros I, Barbosa M, Lopes S, Matta-Coelho C, Monteiro A, Alves M, Souto S, Pereira M

Abstract

Introduction: Obesity, as a marker of metabolic syndrome, is frequently associated with hypertension and dyslipidemia, which improve with weight loss. The aim of this study was to verify the relationship between weight loss and blood pressure and lipid profiles improvement in patients followed in our project named “TObe”, in which obese patients lose weight through an intensive medical intervention, involving Endocrinology and Nutrition. Methods: Retrospective study with 213 patients with obesity, with twelve months of follow up in the “TObe” project and weight, body mass index (BMI), blood pressure and lipid profile assessment at 0 and 12 months. Data was collected from clinical appointments. Statistical analysis was performed with SPSSvs25, with a significance level of 0.05. Results: One hundred sixty four (77%) were female and the mean age was 45.98±12.69 years. Baseline BMI was 39.55 (P25: 36.62; P75: 43.29) kg/m². Patients with hypertension (n=35), dyslipidemia (n=43) or both (n=64) were under medication and controlled. After twelve months, there was a weight reduction of 4.70 (1.40 – 9.35) Kg, p<0.001, BMI reduction of 2.00 (0.60 – 3.98) kg/m2, p<0.001, a systolic blood pressure (SBP) reduction of 3.53 ± 15.40 mmHg, p=0.002, a diastolic blood pressure (DBP) decrease of 1.71 ± 9.66 mmHg, p=0.010, a total cholesterol (Total-C) increase of 6.00 (11.00 – 24.00) mg/dL, p=0.012, a high density lipoprotein cholesterol (HDL-C) increase of 4.00 (0.00 - 10.00) mg/dL, p<0.001, and Apolipoprotein A1 (Apo-A1) increase of 5.47 ± 19.09 mg/dL, p=0.002. BMI variation correlated positively with SBP and DBP variation (r=0.168; p=0.024 and r=0.286; p<0.001, respectively) and negatively with HDL-C variation (r=-0.160; p=0.040). Conclusion: Clinically significant weight loss through lifestyle intervention allowed a reduction of SBP and DBP, and an increase in HDL-C, improving blood pressure and lipid profile, which may reduce the cardiovascular disease risk of patients with obesity.

Portuguese abstract

Introdução: A obesidade, marcador de sindrome metabólica, associa-se frequentemente a hipertensão arterial e dislipidemia, que melhoram com a perda ponderal. Este estudo visa a relação entre perda ponderal e melhoria dos perfis tensional e lipídico em doentes seguidos no nosso projecto “TObe”, no qual doentes com obesidade perdem peso através de uma intervenção médica intensiva por Endocrinologia e Nutrição. Métodos: Estudo retrospectivo com 213 doentes com obesidade, com 12 meses de seguimento no projecto “TObe” e avaliação do peso, índice de massa corporal (IMC), pressão arterial e perfil lipídico aos 0 e 12 meses. Os dados foram colhidos do processo clínico e a análise estatística realizada através do programa SPSSvs25, com nível de significância de 0.05. Resultados: Cento e sessenta e quatro eram do sexo feminino (77%) e a média de idades era de 45,98±12,69 anos. O IMC inicial era de 39,55 (P25: 36,62; P75: 43,29) kg/m². Doentes com hipertensão arterial (n=35), dislipidemia (n=43) ou ambas (n=64) encontravam-se medicados e controlados. Ao fim de 12 meses, verificou-se redução do peso de 4,70 (1,40 – 9,35) Kg, p<0,001, do IMC de 2,00 (0,60 – 3,98) kg/m2, p<0,001, da pressão arterial sistólica (PAS) de 3,53 ± 15,40 mmHg, p=0,002, da pressão arterial diastólica (PAD) de 1,71 ± 9,66 mmHg, p=0,010, aumento do colesterol total (C-Total) de 6,00 (11,00 – 24,00) mg/dL, p=0,012, aumento do colesterol de lipoproteinas de alta densidade (C-HDL) de 4,00 (0,00 – 10,00) mg/dL, p<0,001, e aumento da Apolipoproteina A1 (Apo-A1) de 5,47 ± 19,09 mg/dL, p=0,002. A variação do IMC correlacionou-se positivamente com a variação da PAS e da PAD (r=0,168; p=0,024 e r=0,286; p<0.001, respectivamente) e negativamente com a variação do C-HDL (r=-0,160; p=0,040). Conclusão: Uma perda de peso clinicamente significativa através de medidas de estilo de vida permitiu reduzir a PAS e a PAD, e aumentar o C-HDL, melhorando o perfil tensional e lipídico, o que pode reduzir o risco de doença cardiovascular de doentes com obesidade.