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Study suggests weight-loss surgery may be more successful in controlling hypertension rates – Times of India

Bariatric surgery is more beneficial than blood pressure medications in reducing rates of hypertension, or high blood pressure, in people who are obese and have uncontrolled high blood pressure, according to a study published in the Journal of the American College of Cardiology.

People who underwent bariatric surgery had a lower BMI and took fewer medications after five years while maintaining normal blood pressure levels than those who only used antihypertensive medications.

According to the CDC, adult obesity and hypertension rates in the United States are 41.9 percent and 45.4 percent, respectively.

Obesity is a proven risk factor for cardiovascular disease and a key contributor to high blood pressure, both of which can increase the chances of heart attack, stroke, and heart failure.

“In clinical practice, obesity is an overlooked condition. As a result, obesity is often not addressed as a crucial step in mitigating the risk of important cardiovascular risk factors, including hypertension,” said Carlos Aurelio. Schiavon, MD, FACS, lead author of the study and surgeon specialized in bariatric surgery at the Heart Hospital and BP Hospital in Sao Paulo.

The researchers in this study looked at the impact of obesity treatment on reducing high blood pressure. While there are new medications to treat obesity, long-term medication compliance can be challenging.

This study looks at bariatric surgery as a better long-term solution to managing obesity and, as a result, high blood pressure.


The GATEWAY trial included 100 people (76 percent of whom were women) who had a body mass index (BMI) of around 36.9 kg/m2. All participants had hypertension and were using at least two medications.

People with previous cardiovascular events and poorly controlled type 2 diabetes were excluded.

Subjects were assigned to Roux-en-Y gastric bypass with medical therapy or medial therapy alone and the primary outcome was at least 30 percent reduction in antihypertensive medications while maintaining blood pressure levels below 140/90. mmHg at five years.

At five years, BMI was 28.01 kg/m2 for those receiving bariatric surgery and 36.40 kg/m2 for those receiving medical therapy alone. People who underwent bariatric surgery had an 80.7 percent reduction in the number of medications they took compared to a 13.7 percent reduction in those using medical therapy alone.

Remission of hypertension, defined as blood pressure controlled without medications, was 46.9 percent in those who underwent bariatric surgery compared with 2.4 percent in those who received medical therapy alone.

“Our results underscore the importance of addressing obesity to reduce hypertension rates,” Schiavon said.

Limitations of the study included that it was an open-label, single-center study, with a small sample size, and that some patients were lost to follow-up.

In an accompanying editorial comment, Michael Hall, MD, MSc, professor and chair of the Department of Medicine at the University of Mississippi Medical Center, said the study provides important long-term data on the benefits of gastric bypass on weight loss. and blood pressure. control, but doubts remain.

“More studies are needed that evaluate the threshold for bariatric surgery in people with obesity, the optimal timing of bariatric surgery in obese people with cardiometabolic diseases, the type of bariatric surgery, and comparative studies of pharmacotherapies for obesity and bariatric surgery. to clarify optimal treatment pathways for this common problem and increasing diseases,” he said.

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