A sibutramina pode alterar a pressão sangüínea sistêmica em pacientes obesos? Revisão sistemática e metanálise
Palavras-chave:
Obesidade, Índice de massa corporal, Sobrepeso, Hipertensão, Agentes antiobesidadeResumo
CONTEXTO: Hipertensão arterial sistêmica é parte da síndrome metabólica relacionada à obesidade. OBJETIVO: Avaliar o efeito da sibutramina na pressão arterial sistêmica de pacientes com sobrepeso e obesos através de uma revisão sistemática. MÉTODOS: Tipos de estudos: todos os estudos devem ser controlados e aleatórios. A qualidade metodológica dos estudos selecionados foi acessada usando os critérios descritos no Cochrane Handbook; participantes: pacientes com sobrepeso e obesos; intervenção: sibutramina comparada com placebo. Desfechos primários: pressão arterial sistólica e diastólica; secundário: pressão arterial. Estratégia de busca: os estudos foram identificados das seguintes fontes: Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Medline (Medical Literature Analysis and Retrieval System Online), Cochrane reviews (fontes eletrônicas), manuais, comunicação pessoal e contato com indústria farmacêutica, sem limites. Coleta de dados: dois revisores independentemente obtiveram os artigos completos de todas as publicações elegíveis. RESULTADOS: Três metanálises foram realizadas: no desfecho pressão arterial sistólica, com oito estudos, não houve significância estatística para a diferença entre a sibutramina e o placebo, WMD (weighted mean difference) 1.57, intervalo de confiança (IC) de -0,03 a 3,18; no desfecho pressão arterial diastólica, com 10 estudos, também não houve significância estatística na diferença entre a sibutramina e o placebo, WMD 1.13, IC de -0,49 a 2,76) e no desfecho pressão sangüínea com somente dois estudos, também não foi demonstrada diferença estatisticamente significante entre os grupos experimental e controle, risco relativo de 0,69, IC de 0,07 a 7,01. CONCLUSÃO: O resultado das metanálises apresentadas nesta revisão mostra que a sibutramina utilizada em pacientes obesos, quando comparada ao placebo, não tem efeito estatisticamente significante na pressão arterial.
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