Bariatric Surgery Is Linked to Hypertension Improvement, Remission
A recent clinical trial analyzed 3-year outcomes among patients who underwent Roux-en-Y gastric bypass (RYGB) surgery in order to determine the effectiveness of weight loss surgery for the treatment of hypertension in patients with obesity.1 The researchers examined whether bariatric surgery, compared to medical therapy (MT) alone, had an impact on blood pressure (BP).
The study focused on 100 adult patients with hypertension and mild to moderate obesity. The patients, aged 18 to 65 years, had a body mass index (BMI) of 30.0 to 39.9 kg/m2 at the start of the trial. Previously, the patients had been receiving at least 2 hypertension medications at maximum doses or more than 2 medications at moderate doses.
The primary outcome of the study was a reduction of at least 30% in the number of blood pressure medications while maintaining a BP of 140/90 mm Hg. Overall, this result occurred in 73% of patients who underwent the RYGB surgery and only 11% of the patients who relied on medication alone.
Secondary outcomes of the trial included the number of antihypertensive medications, hypertension remission, and BP control according to current guidelines (<130/80 mm Hg). At 3 years, the median number of medications in the RYGB and MT groups were 1 and 3, respectively. BP of less than 140/90 mm Hg and 130/80 mm Hg were achieved in 35% and 31% of patients who underwent RYGB, respectively, and in 2% and 0% of patients in the MT group, respectively. Total weight loss was 27.8% and -0.1% in the RYGB and MT groups, respectively.
“The latest GATEWAY results showed that early improvements and even remission of high blood pressure in bariatric surgery patients are sustainable over a longer period of time while those on conventional medical treatment continue to face difficulties with both hypertension and obesity, “ said lead study investigator Carlos Aurelio Schiavon, MD, in a press release2. “This new high-level evidence should be factored into the treatment recommendations of cardiologists and primary care doctors who care for patients with obesity and hypertension.”
—Leigh Precopio
References:
- Schiavon CA, Bhatt DL, Ikeoka D, et al. Three-year outcomes of bariatric surgery in patients with obesity and hypertension. August 18, 2020. Ann Intern Med. Doi:10.7326/M19-3781
- Bariatric surgery reduces or eliminates need for blood pressure medication in patients with obesity in new 3-year randomized clinical trial. Johnson & Johnson Medical Devices. August 26, 2020. Accessed August 26, 2020. https://www.jnjmedicaldevices.com/en-US/news-events/bariatric-surgery-reduces-or-eliminates-need-blood-pressure-medication-patients-obesity