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 .
Gastric Bypass Surgery Is Followed by Lowered Blood Pressure and Increased Diuresis - Long Term Results from the Swedish Obese Subjects (SOS) Study
Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake . Background In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain . Methods Cohort study with data from the prospect i ve , controlled Swedish Obese Subjects ( SOS ) study involving 480 primary health care centres and 25 surgical departments in Sweden . Obese patients treated with non-surgical methods ( Controls , n = 1636 and n = 1132 at 2 y and 10 y follow up , respectively ) were compared to patients treated with gastric bypass ( GBP , n = 245 and n = 277 , respectively ) or purely restrictive procedures ( vertical b and ed gastroplasty or gastric b and ing ;  VBG/B , n = 1534 and n = 1064 , respectively ) . Results At long-term follow-up ( median 10 y ) GBP was associated with lowered systolic ( mean : −5.1 mm Hg ) and diastolic pressure ( −5.6 mmHg ) differing significantly from both VBG/B ( −1.5 and −2.1 mmHg , respectively ; p<0.001 ) and Controls ( + 1.2 and −3.8 mmHg , respectively ; p<0.01 ) . Diurnal urinary output was + 100 ml ( P<0.05 ) and + 170 ml ( P<0.001 ) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups , respectively . Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B ( P<0.01 ) . Conclusions The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect , whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis . The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery
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 .