Abstract
Background: Arterial hypertension (HTN) is common among morbidly obese patients undergoing bariatric surgery. The aim of this study is to analyse the prevalence and evolution of HTN and weight loss in patients suffering from morbid obesity before and after bariatric surgery, during a follow-up period of five years. Methods: A before-and-after study was carried out on severely obese patients undergoing Laparoscopic Roux-En-Y Gastric Bypass (LRYGB). Criteria for HTN diagnosis were current treatment with antihypertensive agents and/or systolic blood pressure (SBP) > 140 mmHg and/or diastolic (DBP) > 90 mmHg. HTN remission was defined as normalisation of blood pressure (BP) maintained after discontinuation of medical treatment, and HTN recurrence was considered when HTN diagnostic criteria reappeared after remission. Weight loss during the study period was evaluated for each patient, calculating excess weight loss percentage (% EWL) and BMI loss percentage (% BMIL) with reference to the baseline value. Results: A total of 273 patients were included in the study. HTN was present in 48.2%; 29.4% of hypertensive patients showed HTN remission two years after the surgical procedure, 30.3% of them had relapsed at five years. Conclusion: LRYGB in obese patients is associated with a remission of HTN, and no weight loss differences were observed between the group of patients showing HTN remission at two years and the group who did not. However, differences were observed after the second follow-up year, with an increased weight loss in the remission group, which could indicate that sustained weight loss favours the control of HTN.
Highlights
Introduction published maps and institutional affilEpidemiological studies continue to show an increasing prevalence of obesity worldwide [1,2,3,4,5,6], which has been strongly associated with the development of HTN, along with other major metabolic and cardiovascular risk factors, such as dyslipidaemia and type II diabetes mellitus [7,8,9,10].Raised blood pressure (BP), commonly defined as systolic blood pressure (SBP) ≥ 140 mmHg or DBP ≥ 90 mmHg, is used to identify individuals at high risk of cardiovascular diseases
Three BP readings were taken at one-minute intervals, and the mean value of the second and third readings was used for study analysis
Weight loss during the study period was evaluated for each patient, calculating the percentage of excess weight loss (% EWL) and the percentage of BMI loss regarding the baseline value (% BMIL)
Summary
Epidemiological studies continue to show an increasing prevalence of obesity worldwide [1,2,3,4,5,6], which has been strongly associated with the development of HTN, along with other major metabolic and cardiovascular risk factors, such as dyslipidaemia and type II diabetes mellitus [7,8,9,10]. Raised blood pressure (BP), commonly defined as SBP ≥ 140 mmHg or DBP ≥ 90 mmHg, is used to identify individuals at high risk of cardiovascular diseases. Lifestyle changes, exercise, and behavioural therapy, together with treatment with complementary medication achieve weight loss, improving obesitylinked comorbidities, including HTN. These treatments do not provide the iations
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