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Changes in Central 24-h Ambulatory Blood Pressure and Hemodynamics 12 Months After Bariatric Surgery: the BARIHTA Study

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Abstract

Background

Weight loss is associated to blood pressure (BP) reduction in obese patients. There is no information on central 24-h BP changes after bariatric surgery (BS).

Methods and Results

In this study, we analyzed changes in 24-h BP 12 months following BS, with intermediate evaluations at 1, 3, and 6 months, in severely obese adults. The primary endpoint was aortic (central) 24-h systolic BP changes. Circadian BP patterns and hypertension resolution were also assessed. As secondary endpoints, we analyze changes in central 24-h diastolic BP as well as in all office and ambulatory peripheral BP parameters. Obese adults scheduled for BS as routine clinical care were recruited. We included 62 patients (39% with hypertension, 77% women, body mass index, 42.6 ± 5.5 kg/m2). Reduction in body weight was mean (IQR) 30.5% (26.2–34.4) 1 year after BS. Mean (95% CI) change in central 24-h systolic BP was − 3.1 mmHg (− 5.5 to − 0.7), p = 0.01 after adjustment for age, sex, and baseline hypertensive status. BP parameter changes were different between normotensives and hypertensives. Mean (95% CI) change in central 24-h systolic BP was − 5.2 mmHg (− 7.7 to − 2.7), p < 0.001, in normotensives and − 0.5 mmHg (− 5.1 to 4.0), p = 0.818, in hypertensives. There was a remission of hypertension in 48% of patients. Most patients had a reduced dipping pattern, similarly at baseline and 12 months after BS.

Conclusions

Among patients with severe obesity, there was a substantial central 24-h systolic BP decrease 12 months following BS. Importantly, this change was observed in those patients with normal BP at baseline.

Trial Registration

ClinicalTrials.gov Identifier: NCT03115502

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Acknowledgments

We are indebted to Sara Alvarez, Maria Vera, Berta Xargay, Anna Faura, and Tai Mooi Ho (Nephrology Dpt. Hospital del Mar and Hospital del Mar Medical Research Institute, Barcelona, Spain), for their effort and implication in the study. We are also indebted to Xavier Duran (MStat, PhD, Hospital del Mar Medical Research Institute) for his aid in performing the statistical analyses.

Source of Funding

Research reported in this publication was supported by the Spanish Society of Nephrology and by the Spanish Ministry of Health ISCIII RedinRen RD16/0009/0013. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

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Authors and Affiliations

  1. Hypertension Unit, Nephrology Department, Hospital Universitari del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain

    Anna Oliveras & Susana Vazquez

  2. Nephrology Department, Hospital Universitari del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain

    Anna Oliveras, Laia Sans, Carlos E. Arias, Susana Vazquez & Julio Pascual

  3. Endocrinology Department, Hospital Universitari del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain

    Albert Goday & David Benaiges

  4. Medicine Department, Universitat Autònoma de Barcelona, Centro de Investigaciones Biomédicas en Red de Obesidad y Nutrición, CIBERobn, Instituto de Salud Carlos III, Madrid, Spain

    Albert Goday

  5. General Surgery Department, Hospital Universitari del Mar, Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain

    José Manuel Ramon

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  1. Anna Oliveras
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Correspondence to Anna Oliveras.

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The trial was approved by the local institutional Ethic Committee in accordance with the Declaration of Helsinki, and written informed consent was obtained from all participants.

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Oliveras, A., Goday, A., Sans, L. et al. Changes in Central 24-h Ambulatory Blood Pressure and Hemodynamics 12 Months After Bariatric Surgery: the BARIHTA Study. OBES SURG 30, 195–205 (2020). https://doi.org/10.1007/s11695-019-04107-9

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