Terapia farmacológica antihipertensiva en pacientes adultos con obesidad

Abstract

INTRODUCTION: High blood pressure and obesity are risk factors for cardiovascular diseases that are increasingly common in primary care. Antihypertensive drugs are used to control blood pressure however, metabolic effects and long-term benefits should be considered. OBJECTIVE: To analyze the most appropriate pharmacological treatment for hypertensive patients with obesity at the level of primary health care. MATERIALS AND METHODS: A review was carried out in PubMed, Cochrane and Trip Database, selecting indexed articles from the last five years that contribute to the development of this theme. RESULTS: We found 15 articles that investigated the main pharmacological groups used in hypertension in obese patients. In most of the literature, blockers of the renin angiotensin aldosterone (SRAA) system are recommended as a first line because of their benefits. It was found that calcium channel blockers have neutral metabolic effects. Thiazides are recommended in cases with volume expansion and sodium retention. Finally, the first and second generation beta-blockers do not provide metabolic benefits, while the third generation (vasodilators) manifest neutral and favorable metabolic effects. CONCLUSION: Systematic reviews in the management of hypertension in obese patients recommend the use of SRAA blockers as the first therapeutic option since, due to their indications and adverse effects, they can be applied at all levels of primary health care (considering comorbidities, presence of organic damage, risk factors and response to treatment).