Key result
Taking 2 or more antihypertensive medications prior to Roux-en-Y gastric bypass was associated with an 18-fold higher odds of hypertension non-resolution at 1 year compared to taking 0-1 medications.
Why the study?
The long-term effect of RYGB surgery on HTN is less clear, and data describing characteristics and HTN resolution after bariatric surgery in predominantly African American cohorts are scarce.
Does Roux-en-Y Gastric Bypass (RYGB) surgery lead to hypertension resolution in obese African American patients?
Cohort (n=169)
No
Does Roux-en-Y Gastric Bypass (RYGB) surgery lead to hypertension resolution in obese African American patients?
In an obese African American cohort, the need for ≥ 2 antihypertensive medications prior to Roux-en-Y Gastric Bypass surgery strongly predicts a lower likelihood of hypertension resolution at one year.
Answers are grounded in this paper and cite their sources.
Greater preoperative antihypertensive burden signals poorer hypertension resolution after bypass; leaves open whether this guides patient selection.
Weight reduction continues to be first-line therapy in the treatment of hypertension (HTN). However, the long-term effect of bariatric malabsorptive surgical techniques such as Roux-en-Y Gastric Bypass (RYGB) surgery in the management of hypertension (HTN) is less clear. African Americans (AA) are disproportionately affected by obesity and hypertension and have inconsistent outcomes after bariatric surgery (BS). Despite a plethora of bariatric literature, data about characteristics of a predominantly AA bariatric hypertensive cohort including hypertension in obese (HIO) are scarce and underreported. The aims of this study were, (1) to describe the preoperative clinical characteristics of HIO with respect to HTN status and age, and (2) to identify predictors of HTN resolution one year after RYGB surgery in an AA bariatric cohort enrolled at the Howard University Center for Wellness and Weight Loss Surgery (HUCWWS). In the review of 169 AA bariatric patients, the average BMI was 48.50 kg/m 2 and the average age was 43.86 years. Obese hypertensive patients were older (46 years vs. 37.89 years; p < .0001); had higher prevalence of diabetes mellitus (DM, 43.09% vs. 10.87%; p < .0001) and dyslipidemia (38.2% vs. 13.04%; p 0.002). Hypertensive AA who were taking ≥ 2 antihypertensive medications prior to RYGB were 18 times less likely to experience HTN resolution compared to hypertensive AA taking 0–1 medications, who showed full or partial response. Also, HIO was less likely to resolve after RYGB surgery in patients who needed ≥ 2 antihypertensive medications prior to surgical intervention.
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Gandotra et al. (2021) conducted a cohort in Obesity and hypertension (n=169). Pre-operative antihypertensive medications (≥2) vs. 0-1 pre-operative antihypertensive medications was evaluated on Hypertension non-resolution at 1 year after RYGB surgery (OR 18.574, 95% CI 4.188-82.367, p=0.0001). Taking 2 or more antihypertensive medications prior to Roux-en-Y gastric bypass was associated with an 18-fold higher odds of hypertension non-resolution at 1 year compared to taking 0-1 medications.
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