Predictors of hypertension remission and recurrence after bariatric surgery

Benaiges Foix, David; Sagué Vilavella, Maria; Flores-Le-Roux, Juana Antonia; Pedro-Botet, Juan Carlos; Ramón Moros, José Manuel; Villatoro Moreno, Montserrat; Chillarón Jordan, Juan José; Pera Roman, Manuel Ramón; Más-Lorenzo, Antonio; Grande Posa, Luís; Goday Arno, Alberto

doi:http://dx.doi.org/10.1093/ajh/hpv153

Predictors of hypertension remission and recurrence after bariatric surgery

Citation

Benaiges D, Sagué M, Flores-Le Roux JA, Pedro-Botet J, Ramón JM4, Villatoro M. et al. Predictors of hypertension remission and recurrence after bariatric surgery. Am J Hypertens. 2016 May;29(5):653-9. doi: 10.1093/ajh/hpv153

Abstract

BACKGROUND: Few data exist on factors associated with hypertension (HTN) remission post-bariatric surgery. No information on factors that may predict HTN relapse is available. The aims were to assess the HTN remission and relapse rates at 1 and 3 years, respectively, post-bariatric surgery, and determine predictive factors. METHODS: A nonrandomized prospective cohort study on severely obese patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) with a follow-up of 36 months was conducted between 2005 and 2011. Criteria for HTN diagnosis were current treatment with antihypertensive agents and/or systolic blood pressure (BP) >140mm Hg and/or diastolic BP >90mm Hg. HTN remission was defined as normalization of BP maintained after discontinuation of medical treatment. RESULTS: A total of 197 patients were included in the study. HTN was present in 47.7%; 68.1% of hypertensive patients showed HTN remission 1 year after the surgical procedure, 21.9% of whom had relapsed at 3 years. The number of antihypertensive drugs prior to surgery was associated with a lower remission rate at the first year and a higher recurrence at 3 years. However, a smaller weight loss during the first year was associated with increased HTN recurrence at 3 years. CONCLUSION: HTN relapses in 1 of 5 hypertensives who have achieved remission at the first year of follow-up. Weight loss during the first postoperative year should be encouraged to avoid HTN relapse at 3 years.