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 .
Renal Function and Remission of Hypertension After Bariatric Surgery: a 5-Year Prospective Cohort Study
Purpose This study examines the effect of Roux-en-Y gastric bypass ( RYGB ) and laparoscopic adjustable gastric b and ing ( LAGB ) on renal function for at least 5 years post-operatively in a tertiary referral center for bariatric surgery . Material s and Methods This prospect i ve cohort study of patients undergoing RYGB and LAGB  measured  renal function , blood pressure , and diabetes status pre-operatively and then 1 and 5 years post-operatively . Renal function was assessed using the Modification of Diet in Renal Disease ( MDRD ) , Chronic Kidney Disease Epidemiology Collaboration ( CKD-EPI ) , and Cockcroft-Gault formulae . Hypertension and diabetes were defined by the European Society of Hypertension and European Society of Cardiology joint guidelines and American Diabetes Association guidelines , respectively . A sub-group who had completed 10 years post-operative follow-up was also included . Results Estimated glomerular filtration rate ( eGFR ) increased over 5 years after RYGB ( N = 190 ; 94 ± 2 mL/min/1.73 m2 to 102 ± 22 mL/min/1.73 m2 , p = 0.01 ) and LAGB ( N = 271 ; 88 ± 1 to 93 ± 22 mL/min/1.73 m2 , p = 0.02 ) . In a sub-group with up to 10 years post-operative date , this trend was maintained . In patients with renal impairment , eGFR improved over 5 years ( 52 ± 2 to 68 ± 7 mL/min/1.73 m2 , p = 0.01).Remission of hypertension was greater after RYGB than LAGB at 1 year ( 32 vs. 16 % , p = 0.008 ) and at 5 years post-operatively ( 23 vs. 11 % , p = 0.02 ) . Conclusions Bariatric surgery stabilizes eGFR post-operatively for at least 5 years . In a sub-group with renal impairment , eGFR is increased in the first post-operative year and this is maintained for up to 5 years . RYGB is an effective procedure in achieving blood pressure control
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 .