1138 Intragastric Balloon on Blood Pressure Reduction in a Gastroenterology Practice in Eastern Northern Carolina: A Retrospective Review

Abstract

INTRODUCTION: Obesity is a global pandemic and a major health concern contributing to cardiovascular disease (CVD). Cardiovascular disease (CVD) causes nearly 18 million deaths yearly. Amongst the CVD risk factors, hypertension remains the leading cause of excessive premature mortality and morbidity. The consequences of hypertension are of momentous impact on public health. It is estimated that nearly 1.5 billion adults in the world will have hypertension in the decade ahead. If this trend is not reversed, the ramifications do not bode well for the pandemic of CVD. The highest CVD hospitalization rates are clustered primarily in rural Eastern North Carolina (ENC), a pattern similar to that of all CVD death rates. Also, the prevalence of obesity and HTN in ENC are comparable. Bariatric surgery is the most effective weight (wt.) reduction intervention with short- and long-term health improvements. However, little is known about endoscopic bariatric therapy, such as intragastric balloon therapy (IGBT) on HTN improvement. METHODS: Retrospective chart review between January 1, 2016, and January 31, 2019, of adults who received IGBT in a GI practice in ENC. Data collection comprised patient demographics. The primary outcome was wt. reduction, expressed as kilograms lost, and % wt. loss at 3 and 6 months after IGB. The secondary outcome was the impact of weight reduction on hypertension (cut off SBP/DBP: 140/90) post-implantation at 6 months. Logistic regression analyses were performed to determine the association between weight and hypertension at 6- months post-implantation. Statistical analysis was done using STATA 14. RESULTS: See Table 1 for baseline demographics. Wt. was found to be a significant factor in determining SBP given the JNC 8 guidelines (β = 0.0140, P < 0.000). These results indicate that for every increase in wt., the log odds of SBP will increase by 1.4%. These results indicate that for every increase in wt, the log odds of hypertension will increase by 1.2%. No association was shown between wt. and DBP. 11 patients requested early removal (IGB removal in the first two weeks to one-month post-implantation). Of the 11, 10 patients reported intolerable side effects, such as intractable nausea, vomiting, diarrhea, and abdominal pain; and one patient reported a sensation of a foreign body. CONCLUSION: There was a statistically significant wt reduction post-implantation. Statistically significant correlation was found between wt reduction and changes in SBP at 6 months post-implantation.