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 .
Ghrelin and obestatin levels in hypertensive obese patients
Objectives To investigate plasma total ghrelin and obestatin levels and the ghrelin/obestatin ratio prospect ively , in hypertensive obese patients . Methods Height , weight , and waist and hip circumferences were measured in hypertensive and normotensive obese patients and matched healthy controls ; the body mass index and waist to hip ratio were calculated . Fasting glucose and insulin levels were measured and the homeostasis model assessment of insulin resistance ( HOMA-IR ) was determined . Fasting ghrelin and obestatin concentrations were measured by radioimmunoassay and the ghrelin/obestatin ratio was calculated . Results A total of 38 hypertensive obese patients , 40 normotensive obese patients and 38 controls were enrolled . Hypertensive obese patients had lower plasma levels of ghrelin and obestatin than normotensive obese patients or controls . In addition , normotensive obese patients had lower plasma ghrelin and obestatin levels than controls . In hypertensive obese patients , ghrelin and obestatin levels were negatively associated with systolic and diastolic blood pressure , fasting insulin and HOMA-IR . In normotensive obese patients , ghrelin , obestatin and the ghrelin/obestatin ratio were negatively associated with fasting insulin and HOMA-IR . In both patient groups , fasting obestatin and ghrelin concentrations were significantly and positively correlated with each other . Conclusion Changes in the levels of ghrelin and obestatin may play a role in the pathophysiology of obesity 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 .