Key result
ESC criteria yield a ~59% post-bariatric hypertension remission rate, outperforming stricter AHA guidelines.
Why the study?
Dissimilar hypertension guidelines from AHA and ESC may lead to different assessments of hypertension diagnosis and remission after bariatric surgery in patients with obesity.
Does the application of AHA versus ESC guidelines affect the reported rates of hypertension remission in patients 1 year after bariatric surgery?
Cohort (n=153)
No
Does the application of AHA versus ESC guidelines affect the reported rates of hypertension remission in patients 1 year after bariatric surgery?
Applying stricter AHA guidelines versus ESC guidelines results in a higher baseline prevalence of hypertension and a slightly lower reported remission rate one year after bariatric surgery, though differences are minimal.
Answers are grounded in this paper and cite their sources.
Guideline choice modestly affects reported post-bariatric hypertension remission rates; leaves open which criteria best predict cardiovascular outcomes.
BACKGROUND/OBJECTIVES: Obesity remains a global health concern and is associated with increased risk of type 2 diabetes, hypertension, and cardiovascular disease overall. Dissimilar hypertension guidelines are available for clinicians, namely those prepared by the American Heart Association (AHA) and the European Society of Cardiology (ESC), which may lead to distinctive appreciation of health outcomes of patients with obesity after bariatric and metabolic surgery, such as hypertension remission. The main goal of this study was to compare the effects of applying stricter (AHA) versus looser (ESC) blood pressure criteria on hypertension diagnosis pre-bariatric surgery and remission assessment one year post-op. METHODS: A retrospective analysis of clinical data from patients who underwent surgical treatment for obesity at a single university hospital was performed. To evaluate the hypertension improvement or remission, two different types of blood pressure (BP) categorization were considered (based on AHA and ESC guidelines), in which each patient would fit according to their BP values pre- (m0) and 12 months postoperative (m12). CONCLUSIONS: We conclude that only minor differences exist between the two guidelines used. If evaluated based on ESC guidelines, it is expected that less patients are considered with hypertension, and the remission rate may be, at least numerically, higher.
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Dias et al. (2025) conducted a cohort in Obesity and Hypertension (n=153). European Society of Cardiology (ESC) guidelines classification vs. American Heart Association (AHA) guidelines classification was evaluated on Hypertension remission rate at 12 months post-bariatric surgery (p=<0.001). Applying the less strict ESC guidelines resulted in a higher hypertension remission rate compared to the stricter AHA guidelines at one year post-bariatric surgery.
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