The role of bariatric surgery for improvement of hypertension in obese patients: a retrospective study

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Abstract

Objective

Evaluate if bariatric surgery can improve hypertension (HPT) control leading to both reduction of blood pressure values and antihypertensive therapy withdrawal.

Methods

Eight-hundred and sixty-four consecutive patients who referred to our hospital, from March 2001 to February 2011, because of morbid obesity were initially enrolled in this retrospective study. To obtain two comparable groups, propensity-matching was applied. Finally, the study included 444 (51% out of initial 864 patients), 222 on diet (group D) and 222 patients undergoing surgery (group S).

Results

In group D, sistolic blook pressure (SBP) showed a significant increase (135 ± 14 vs 138 ± 11 mmHg; P = 0.006); conversely in group S, SBP decreased (130 ± 14 vs 124 ± 9 mmHg; P = 0.001). In group D, diastolic blood pressure (DBP) showed a significant increase (80 ± 6 vs 82 ± 6 mmHg; P = 0.004); conversely in group S, DBP decreased (81 ± 9 vs 79 ± 8 mmHg; P = 0.015). Among 136 patients with HPT, 73 (53%) withdrew antihypertensive therapy: significantly more in group S (55/63, 87%) than in group D (17/56, 23%), P < 0.001. The median weight loss was significantly higher in group S than in group D at 6 months [4 (3–7) vs 15 (10–20)], 12 months [6 (4–9) vs 19 (12–28)] and 18 months [6 (2–10) vs 20 (13–32)]. Loss of weight is greater in the subgroup with HPT having surgery.

Conclusion

Bariatric surgery is effective to improve SBP and DBP and leads to therapy withdrawal in obese patients; these changes are directly related to the amount of weight loss.

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