Evidence suggests significant improvement in obesity-hypertension in patients who undergo surgical weight-reduction procedures .
Malabsorptive techniques such as the Roux-en-Y gastric bypass or surgical resection techniques such as laparoscopic sleeve gastrectomy appear to offer superior results in regards to hypertension control over restrictive techniques such as Gastric B and ing .
Though long-term control of hypertension following surgery remains a concern , available follow-up post-operative data of up to 10 years suggests a sustained , if lessened , effect on hypertension control over time
Obesity continues to increase in prevalence worldwide .
Hypertension has long been associated with obesity , and weight loss continues to be a first-line therapy in the treatment of hypertension .
Lifestyle modification and pharmacologic therapy , however , often meet with treatment failure .
Bariatric surgery continues to be the most successful approach to sustained weight loss .
This review focuses on the underlying physiologic mechanisms of obesity-hypertension , and the impact of bariatric surgery on the treatment of hypertension .
Intra-abdominal pressure, sagittal abdominal diameter and obesity comorbidity.
OBJECTIVES To determine relationship of intra-abdominal pressure to central obesity and the comorbidity of obesity . DESIGN Non-r and omized , prospect i ve . SETTING University hospital , operating room . SUBJECTS Eighty-four anaesthetized consecutive patients prior to gastric bypass for morbid obesity and five non-obese patients before colectomy for ulcerative colitis . MAIN OUTCOME MEASURES Weight , body mass index ( BMI ) , co-morbid history , sagittal abdominal diameter , waist : hip ( W : H ) ratio and urinary bladder pressure , as an estimate of intra-abdominal pressure . RESULTS Urinary bladder pressure was greater in the obese than the non-obese ( 18 + /- 0.7 vs. 7 + /- 1.6 cm H2O , P < 0.001 ) , correlated with sagittal abdominal diameter ( r = + 0.67 , P < 0.001 ) and was greater ( P < 0.05 ) in patients with , than those without , morbidity probably ( hypoventilation , gastroesophageal reflux , venous stasis , stress incontinence , incisional hernia ) or possibly ( hypertension , diabetes ) due to increased abdominal pressure . W : H ratio correlated with urinary bladder pressure in men ( r = + 0.6 , P < 0.05 ) but not women ( r = -0.3 ) . CONCLUSIONS Increased sagittal abdominal diameter was associated with increased intraabdominal pressure which contributed to obesity-related comorbidity . W : H ratio was not a reliable indicator of intra-abdominal pressure for women who often have both peripheral and central obesity . Further studies are needed to evaluate the relationship between intra-abdominal pressure and Type II diabetes and hypertension
Evidence suggests significant improvement in obesity-hypertension in patients who undergo surgical weight-reduction procedures .
Malabsorptive techniques such as the Roux-en-Y gastric bypass or surgical resection techniques such as laparoscopic sleeve gastrectomy appear to offer superior results in regards to hypertension control over restrictive techniques such as Gastric B and ing .
Though long-term control of hypertension following surgery remains a concern , available follow-up post-operative data of up to 10 years suggests a sustained , if lessened , effect on hypertension control over time
Obesity continues to increase in prevalence worldwide .
Hypertension has long been associated with obesity , and weight loss continues to be a first-line therapy in the treatment of hypertension .
Lifestyle modification and pharmacologic therapy , however , often meet with treatment failure .
Bariatric surgery continues to be the most successful approach to sustained weight loss .
This review focuses on the underlying physiologic mechanisms of obesity-hypertension , and the impact of bariatric surgery on the treatment of hypertension .