original article

Journal of Gastrointestinal Surgery

, Volume 13, Issue 4, pp 793-797

Open Access This content is freely available online to anyone, anywhere at any time.

Resolution of Systemic Hypertension after Laparoscopic Gastric Bypass

  • Marcelo W. HinojosaAffiliated withDepartment of Surgery, University of California, Irvine Medical Center
  • , J. Esteban VarelaAffiliated withDepartment of Surgery, University of Texas Southwestern
  • , Brian R. SmithAffiliated withDepartment of Surgery, University of California, Irvine Medical Center
  • , Fredrick CheAffiliated withDepartment of Surgery, University of California, Irvine Medical Center
  • , Ninh T. NguyenAffiliated withDepartment of Surgery, University of California, Irvine Medical CenterDivision of Gastrointestinal Surgery, University of California, Irvine Medical Center Email author 

Abstract

Background

Hypertension is a well-recognized and treatable risk factor for coronary heart disease and is one of the most common comorbidities associated with obesity. The aim of this study was to characterize the clinical outcome of a cohort of patients with documented hypertension who underwent laparoscopic gastric bypass.

Methods

Ninety-five obese patients with documented hypertension and being treated with antihypertensive medication(s) underwent laparoscopic gastric bypass. Main outcome measures included length of hypertensive condition, changes in systolic and diastolic blood pressures, and changes in antihypertensive medication(s) at follow-up.

Results

There were 69 (72%) females with a mean preoperative body mass index of 47 kg/m2. The mean duration of hypertension was 73 ± 70 months. The mean excess body weight loss at 12 months was 66%. The mean systolic blood pressure significantly decreased from 140 ± 17 mmHg preoperatively to 120 ± 18 mmHg at 12 months (p < 0.01). The mean diastolic blood pressure also significantly decreased from 80 ± 11 mmHg preoperatively to 71 ± 8 mmHg at 12 months (p < 0.01). At 12 months follow-up, 44 (46%) patients had complete resolution of hypertension while 18 (19%) patients had improvement. Patients with complete resolution had a shorter duration of disease as compared to patients without resolution (53 vs. 95 months, respectively, p = 0.01).

Conclusion

Weight loss associated with laparoscopic gastric bypass substantially improves and/or resolves hypertension in the majority of patients. Improvement of hypertension occurs as early as 1 month postoperatively and is more frequently in patients with a shorter preoperative duration of disease.

Keywords

Bariatric surgery Morbid obesity Systemic hypertension Gastric bypass