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Bariatric surgery is more effective at reducing blood pressure rates or controlling high blood pressure than blood pressure medication in people with obesity and uncontrolled high blood pressure, according to a study published today in the Journal of the American College of Cardiology.
People who had bariatric surgery had a lower BMI and were on fewer medications after five years, while blood pressure levels remained normal, compared with those who only used antihypertensive medications. .
According to the CDC, the rates of obesity and high blood pressure among adults in the US are 41.9 percent and 45.4 percent, respectively.
Also read: How bariatric surgery slows cognitive decline in obese people: Study
Obesity is a proven risk factor for heart disease and a major contributor to high blood pressure, both of which can increase the chance of heart attack, stroke and heart failure.
Carlos Aurelio Schiavone, MD, FACS, said, “In clinical practice, obesity is an overlooked condition. As a result, obesity management is recognized as an important step in reducing the risk of important cardiovascular risk factors, including hypertension.” There is often failure to adopt.” The author of the study and a surgeon specializing in bariatric surgery at the Heart Hospital and BP Hospital in Sao Paulo.
In this study, researchers looked at the effect of treating obesity in reducing high blood pressure. Although there are new medications available to treat obesity, staying on medication for a long period of time can be challenging.
This study sees bariatric surgery as a better long-term solution to control obesity and its resulting high blood pressure.
The Gateway trial included 100 people (76 percent of whom were women) who had a body mass index (BMI) of about 36.9 kg/m2. All participants had high blood pressure and were using at least two medications.
People with previous cardiovascular events and poorly controlled type 2 diabetes were excluded. Subjects were assigned either Roux-en-Y gastric bypass with medical therapy or medial therapy alone and the primary outcome was at least a 30 percent reduction in antihypertensive medications while maintaining blood pressure levels less than 140/90 mmHg over five years. Was.
Over five years, BMI was 28.01 kg/m2 for those who underwent bariatric surgery and 36.40 kg/m2 for those receiving medical therapy alone. Those who had bariatric surgery reduced the number of medications they took by 80.7 percent, compared with 13.7 percent for those who used only medical therapy.
The reduction in high blood pressure, defined as blood pressure controlled without medications, was 46.9 percent in those who had bariatric surgery, compared with 2.4 percent in those who received medical treatment alone.
“Our results underscore the importance of approaching obesity in reducing rates of hypertension,” Schiavone said.
Limitations of the study included that it was a single-center, open-label study with a small sample size and that some patients were lost to follow-up.
In an accompanying editorial comment, Michael Hall, MD, MSc, professor and chair of the department of medicine at the University of Mississippi Medical Center, said the study provides important long-term data on the benefits of gastric bypass on weight loss and blood pressure. Control, but questions remain.
“Further studies assessing the extent of bariatric surgery in obese people, the optimal timing of bariatric surgery in obese people with cardiometabolic diseases, types of bariatric surgery, and comparative studies of obesity pharmacotherapy and bariatric surgery are needed to determine whether this common To clarify the optimal treatment pathways for the disease and the progression of the disease,” he said.
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