Effect of Surgically-induced Weight Loss in African-Americans with Hypertension

Abstract

The objective of this study was to determine BP control and effect of weight loss in African-Americans (AA) compared to non-African-Americans (non-AA). Subjects with hypertension with evaluable data at 2 years from the on-going APEX study, which examines the effect of laparoscopic adjustable gastric banding (LAGB) (LAP-BAND® AP) in patients with a BMI>35 on weight and comorbidities. Hypertension was defined as a history of hypertension or a BP of >140/90 at screening; 209/395 (52.9%) met this definition. Mean age=42.6 yr; 81.4% were female. Control of known hypertension was similar at baseline in AA vs. non-AA: 11/21(52.4%) and 97/181(53.6%) respectively, although 44% of AA had undiagnosed hypertension compared to 31% non-AA. Two years after LAGB, AA with uncontrolled hypertension at baseline lost a mean body weight of 20.2% (25.9kg); mean SBP(mmHg) decreased from 150.7 to 133.6(-17.1) and mean DBP decreased from 93.1 to 84.7(-8.4). AA with controlled BP at baseline lost 18.9% of body weight; SBP decreased 3.4 (122.8 to 119.4) and DBP 4.1 (79.7 to 75.6). In non-AA uncontrolled at baseline SBP decreased 17.8(151.0 to 133.1) and DBP 7.1(89.9 to 82.7). Baseline wt(129.5kg) and % change in wt(-19.7%) was similar to AA's. In conclusion, hypertension is common in relatively young morbidly obese individuals and more likely to be unrecognized in AA patients. However, the effect of LAGB-induced weight loss was equally effective in African-Americans and non-African-Americans, suggesting that LAGB may be considered as part of the hypertension treatment paradigm in morbidly obese subjects, particularly those with higher overall cardiovascular risk.