Bariatric surgery reduced antihypertensive therapy use from 64.1% at baseline to 39.4% at 10 years (p<0.001), though blood pressure returned to baseline levels despite sustained weight loss.
Cohort (n=170)
Does bariatric surgery improve blood pressure and reduce antihypertensive therapy use in patients with obesity?
Bariatric surgery provides short-term reductions in blood pressure and antihypertensive use, but blood pressure returns to baseline by 10 years despite sustained weight loss.
Absolute Event Rate: 39.4% vs 64.1%
p-value: p=<0.001
Objective: ESH 2023 recommends weight reduction in adults with obesity to lower blood pressure (Class I, Level A). Bariatric surgery (BS) is the most effective obesity treatment. This study assessed the impact of BS on blood pressure at 1-year and 10-year follow-up. Design and method: Patients undergoing BS between 2010 and 2014 were evaluated before surgery and at 1 and 10 years postoperatively. All participants underwent 24-hour ambulatory blood pressure monitoring. Hypertension was defined as the use of antihypertensive medication and/or a mean 24-hour blood pressure greater than or equal to 130/80 mmHg. Results: 170 patients (mean age 42.9 ± 10.0 years; 77.6% women) with a median BMI of 41.8 (38.2–46.3) kg/m2 were analyzed. Sleeve gastrectomy was performed in 74.7%, and gastric bypass in 25.3%. At baseline, 34.1% received antihypertensive therapy, 12.3% hypoglycemic agents, and 11.2% lipid-lowering medications. Total weight loss was 29.9 ± 9.0% at 1 year and 20.6 ± 12.1% at 10 years. Detailed results are shown in the table.Antihypertensive therapy decreased from 64.1% at baseline to 34.1% at 1 year and 39.4% at 10 years (both p < 0.001). Multivariable analysis at 1 year showed age (OR 0.94 0.90–0.98, p = 0.004) and baseline number of antihypertensive medications (OR 0.38 0.26–0.57, p < 0.001) were independently associated with hypertension remission. At 10 years, baseline mean blood pressure (OR 0.94 0.90–0.99, p = 0.011) and baseline number of antihypertensives (OR 0.41 0.28–0.62, p < 0.001) were independently associated with hypertension relapse. Conclusions: BS resulted in significant short-term reductions in blood pressure and antihypertensive therapy use. However, at 10-year follow-up, blood pressure returned to baseline levels despite sustained weight loss, emphasizing the need for continued cardiovascular risk monitoring and management in this population.
Humięcka et al. (Fri,) conducted a cohort in Obesity (n=170). Bariatric surgery vs. Baseline was evaluated on Antihypertensive therapy use at 10 years (p=<0.001). Bariatric surgery reduced antihypertensive therapy use from 64.1% at baseline to 39.4% at 10 years (p<0.001), though blood pressure returned to baseline levels despite sustained weight loss.