BP Control Improved With Gastric Bypass in Patients With Obesity, Hypertension

Feb 07, 2024

For individuals with obesity and hypertension, bariatric surgery is associated with improved hypertension control, according to a study published in the Feb. 13 issue of the Journal of the American College of Cardiology.

Carlos A. Schiavon, M.D., from the Heart Hospital in São Paulo, Brazil, and colleagues determined the long-term effects of bariatric surgery on hypertension control and remission in a randomized clinical trial involving individuals with obesity grade 1 or 2 plus hypertension. One hundred individuals were assigned to Roux-en-Y gastric bypass (RYGB) combined with medical therapy (MT) or MT alone.

The researchers found that the body mass index was 36.40 and 28.01 kg/m² for MT and RYGB, respectively, at five years. RYGB promoted a significantly higher rate of number of medications with at least a 30 percent reduction compared with MT (80.7 versus 13.7 percent; relative risk, 5.91); the mean number of antihypertensive medications was 2.97 and 0.80 for RYGB and MT, respectively. Hypertension remission occurred in 2.4 and 46.9 percent, respectively (relative risk, 19.66 percent). The results were consistent in a sensitivity analysis considering only completed cases. After RYGB, the rate of apparent resistant hypertension was lower (0 versus 15.2 percent).

“Further studies assessing the threshold (mean body mass index versus other measures of adiposity) for bariatric surgery in people with obesity, optimal timing of bariatric surgery in obese people with cardiometabolic diseases (e.g., after certain duration of obesity), type of bariatric surgery (RYGB versus sleeve gastrectomy), and comparative studies of obesity pharmacotherapies and bariatric surgery are needed to clarify the optimal treatment pathways for this common and growing disease,” write the authors of an accompanying editorial.

Several authors disclosed ties to the pharmaceutical and medical device industries.

Abstract/Full Text (subscription or payment may be required)

Editorial (subscription or payment may be required)