Key result
Bariatric surgery significantly increased the rate of antihypertensive therapy withdrawal compared to diet alone in obese patients with hypertension (87% vs 23%, P<0.001).
Why the study?
Does bariatric surgery improve blood pressure and lead to antihypertensive therapy withdrawal in morbidly obese patients compared to diet alone?
Cohort (n=444)
No
Does bariatric surgery improve blood pressure and lead to antihypertensive therapy withdrawal in morbidly obese patients compared to diet alone?
Absolute Event Rate: 87% vs 23%
p-value: p=<0.001
Bariatric surgery significantly reduces blood pressure and facilitates the withdrawal of antihypertensive medications in morbidly obese patients compared to diet alone.
May support greater antihypertensive withdrawal with bariatric surgery in obese hypertension; leaves open need for randomized confirmation.
OBJECTIVE: Evaluate if bariatric surgery can improve hypertension (HPT) control leading to both reduction of blood pressure values and antihypertensive therapy withdrawal. METHODS: Eight-hundred and sixty-four consecutive patients who referred to our hospital, from March 2001 to February 2011, because of morbid obesity were initially enrolled in this retrospective study. To obtain two comparable groups, propensity-matching was applied. Finally, the study included 444 (51% out of initial 864 patients), 222 on diet (group D) and 222 patients undergoing surgery (group S). RESULTS: In group D, sistolic blook pressure (SBP) showed a significant increase (135 ± 14 vs 138 ± 11 mmHg; P = 0.006); conversely in group S, SBP decreased (130 ± 14 vs 124 ± 9 mmHg; P = 0.001). In group D, diastolic blood pressure (DBP) showed a significant increase (80 ± 6 vs 82 ± 6 mmHg; P = 0.004); conversely in group S, DBP decreased (81 ± 9 vs 79 ± 8 mmHg; P = 0.015). Among 136 patients with HPT, 73 (53%) withdrew antihypertensive therapy: significantly more in group S (55/63, 87%) than in group D (17/56, 23%), P < 0.001. The median weight loss was significantly higher in group S than in group D at 6 months [4 (3-7) vs 15 (10-20)], 12 months [6 (4-9) vs 19 (12-28)] and 18 months [6 (2-10) vs 20 (13-32)]. Loss of weight is greater in the subgroup with HPT having surgery. CONCLUSION: Bariatric surgery is effective to improve SBP and DBP and leads to therapy withdrawal in obese patients; these changes are directly related to the amount of weight loss.
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Petroni et al. (2016) conducted a cohort in Morbid obesity and hypertension (n=444). Bariatric surgery vs. Diet was evaluated on Antihypertensive therapy withdrawal (p=<0.001). Bariatric surgery significantly increased the rate of antihypertensive therapy withdrawal compared to diet alone in obese patients with hypertension (87% vs 23%, P<0.001).
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