Bariatric Surgery and Hypertension

Abstract 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. Bar...

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Bibliographic Details
Published in:American journal of hypertension 2018-01, Vol.31 (1), p.11-17
Main Authors: Owen, Jonathan G, Yazdi, Farshid, Reisin, Efrain
Format: Article
Language:English
Subjects:
Bariatric Surgery
Humans
Hypertension - etiology
Hypertension - physiopathology
Hypertension - therapy
Obesity - complications
Obesity - physiopathology
Obesity - surgery
Obesity, Morbid - surgery
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Summary:Abstract 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. Current available literature on the physiologic mechanisms of obesity-hypertension, and the major trials, meta-analyses and systematic reviews of the impact of bariatric surgery procedures on hypertension are reviewed. 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 Banding. 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.
ISSN:0895-7061
1941-7225
DOI:10.1093/ajh/hpx112