- Researchers say people with obesity who had bariatric surgery had lower blood pressure, better body mass index scores, and used less medication than those who only used drugs to control hypertension.
- They say their five-year study demonstrates the lasting health benefits of bariatric surgery.
- Exercise, improved diet, quitting smoking, and getting better sleep also can reduce blood pressure.
Hypertension is common among people with obesity, but people who undergo bariatric surgery to control their weight are better able to lower their blood pressure than those taking antihypertensive medication alone.
That’s according to a study published today in the Journal of the American College of Cardiology.
Researchers reported that individuals who underwent bariatric surgery — procedures involving the digestive system designed to limit the amount of food that can be consumed at one sitting — were more likely to maintain normal blood pressure medication and had lower body mass index (BMI) scores after five years than people with obesity who did not have the surgery.
“Bariatric surgery treats the underlying cause of high blood pressure rather than just dilating the blood vessels” like antihypertensive medications do, said Dr. Mitchell Roslin, the director of bariatric surgery at Northern Westchester Hospital in New York who was not involved in the research.
“Obesity is a symptom of metabolic overload, so if you’re not addressing that, you’re not addressing the problem,” he explained to Medical News Today.
“In clinical practice, obesity is an overlooked condition,” said Dr. Carlos Aurelio Schiavon, the lead author of the study and a surgeon specializing in bariatric surgery at Heart Hospital and BP Hospital in Sao Paulo, Brazil, in a press statement. “As a consequence, there is a frequent failure in approaching obesity as a crucial step for mitigating the risk of important cardiovascular risk factors, including hypertension.”
The study included 100 participants, about three-quarters of whom were female.
At the beginning of the study, the subjects had an average BMI of nearly 37Kg/m2, had high blood pressure, and were taking at least two medications.
When assessed at five years, nearly 47% of those who underwent bariatric surgery had controlled their blood pressure without medications, compared to 2% of those who only received medical therapy.
BMI was 28Kg/m2 for those who received bariatric surgery and 36Kg/m2 for those on medical therapy alone. The participants who had bariatric surgery had reduced their medication use by 80% while non-surgical participants only reduced medication use by 13%.
“Bariatric surgery has lasting effects,” said Roslin. “It has been shown to have more long-term benefits than any other surgical procedure,” including reducing cancer and cardiac mortality as well as hypertension.
In a commentary accompanying the published study, Dr. Michael Hall, a professor and chair of the Department of Medicine at the University of Mississippi Medical Center, said further studies are needed to assess “the threshold for bariatric surgery in people with obesity, optimal timing of bariatric surgery in obese people with cardiometabolic diseases,” and the type of bariatric surgery that’s most effective.
“[C]omparative studies of obesity pharmacotherapies and bariatric surgery are needed to clarify the optimal treatment pathways for this common and growing disease,” he added.
“In addition to sustained weight loss having a great effect on reducing blood pressure medications, there are additional metabolic effects that result from bariatric surgery,” Dr. Mir Ali, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California who was not involved in the research, told Medical News Today. “Not all these effects are well understood and research continues to better comprehend these effects.”
“If patients have hypertension secondary to obesity, then any way a patient can get to a healthy weight — by diet, exercise, medications, etc. — they are more likely to be able to reduce blood pressure,” Ali added. “Additionally, reducing alcohol and nicotine use, reducing salt intake, proper sleep, reducing stress and regular exercise all have beneficial effects on blood pressure.”
“Good aerobic exercise can increase your natural nitroglycerin, which is a vasodilating agent,” Dr. Nicole Weinberg, a cardiologist at Providence Saint John’s Health Center in California who was not involved in the research, told Medical News Today. “This causes your blood vessels to dilate and lowers your blood pressure.”