Recent analysis presented at the American Heart Association’s Hypertension Scientific Sessions 2024 suggests that weight-loss surgery, or bariatric surgery, may be more effective than conventional treatments in managing high blood pressure for people with obesity.
The study, which synthesizes data from 18 randomized controlled trials involving over 1,300 participants, highlights the potential benefits of bariatric surgery in controlling hypertension. This research builds on previous findings and offers new insights into how surgical weight loss can impact blood pressure management.
Key Findings
Increased Likelihood of Blood Pressure Remission: Participants who underwent weight-loss surgery were 2.77 times more likely to achieve blood pressure remission (less than 140/90 mm Hg) without medication.
Enhanced Blood Pressure Control: These individuals were 7.1 times more likely to control their blood pressure (less than 130/80 mm Hg) while significantly reducing their reliance on medication.
Reduction in Systolic Blood Pressure: On average, those who had surgery experienced a 3.67 mm Hg reduction in systolic blood pressure compared to those who managed hypertension with medications and lifestyle changes.
Dr. Sneha Annie Sebastian, the study’s lead author, points out that bariatric surgery appears to provide a durable solution for obesity-related hypertension. It not only helps in achieving long-term blood pressure control but also reduces the need for antihypertensive medications. Improved blood pressure control from surgery can also lower cardiovascular risk and enhance overall heart health.
How Bariatric Surgery Works
Bariatric surgery involves reducing the size of the stomach or altering the digestive system to promote weight loss. This can make individuals feel fuller on smaller amounts of food and may reduce nutrient and calorie absorption. The 2022 guidelines from the American Society for Metabolic and Bariatric Surgery suggest this type of surgery for individuals with a body mass index (BMI) of 35 kg/m² or higher, regardless of associated health conditions.
Study Details
Participant Demographics: The analysis included 1,386 adults with obesity (average BMI of 38 kg/m²), with 62.7% identifying as women and 37.3% as men.
Surgical Procedures Studied: Most participants underwent Roux-en-Y gastric bypass or sleeve gastrectomy.
Follow-Up Duration: The studies included in the analysis had follow-up periods ranging from 1 to 5 years.
Future Directions
The authors call for further randomized controlled trials with long-term follow-up and larger sample sizes to better understand the impact of bariatric surgery on hypertension outcomes. They also suggest comparing bariatric surgery with newer weight-loss medications to identify the most suitable options for different patient profiles.
Dr. Michael E. Hall, chair of the writing group for the Association’s 2021 scientific statement on weight-loss strategies, acknowledges the effectiveness of bariatric surgery but emphasizes the need for studies comparing it with newer medications. “Bariatric surgery is an effective and durable treatment option for hypertension related to obesity,” he says, “but further research is needed to refine treatment strategies and evaluate cost-effectiveness.”
Overall, this analysis reinforces the role of bariatric surgery as a promising option for managing high blood pressure in individuals with obesity, highlighting its potential benefits in improving cardiovascular health.
