A new study published in the Journal of the American College of Cardiology has revealed that bariatric surgery is much more effective at managing high blood pressure, also known as hypertension, in obese individuals than relying on blood pressure medication alone.
This research highlights a critical development for those struggling with both obesity and uncontrolled hypertension.
It shows that patients undergoing bariatric surgery not only achieved lower body mass index (BMI) figures but also reduced their dependency on medications, maintaining normal blood pressure levels over five years.
Obesity and hypertension are prevalent issues in the United States, with the CDC reporting rates of 41.9% and 45.4%, respectively, among adults.
Given the strong link between obesity and cardiovascular diseases—such as heart attacks, strokes, and heart failure—the study’s findings offer hope for a more effective treatment strategy that addresses the root cause of hypertension in many patients: obesity.
Carlos Aurelio Schiavon, MD, FACS, a leading figure in the study, pointed out the critical oversight in clinical practice where obesity is often not addressed as a key factor in managing cardiovascular risks, including hypertension.
The study, therefore, shines a light on the importance of treating obesity as a primary step towards reducing the risk of hypertension.
The research was conducted through the GATEWAY trial, which included 100 participants, predominantly female, with an average BMI of 36.9kg/m^2, all of whom were suffering from hypertension and on at least two antihypertensive medications.
The study specifically excluded individuals with previous cardiovascular events and those with poorly controlled type 2 diabetes.
Participants were divided into two groups: one received Roux-en-Y gastric bypass surgery alongside medical therapy, while the other was treated with medical therapy alone.
The primary goal was to achieve a significant reduction in antihypertensive medications while keeping blood pressure below 140/90 mmHg after five years.
The outcomes were compelling. The surgery group saw their BMI drop to 28.01 kg/m^2, in stark contrast to the 36.40 kg/m^2 in the medication-only group.
Furthermore, the surgery group experienced an 80.7% reduction in the number of medications needed, compared to a mere 13.7% reduction in the control group.
Remarkably, 46.9% of the surgery group achieved hypertension remission without the need for any medication, a figure that was only 2.4% in the medication-alone group.
Despite these promising results, the study does have its limitations.
An editorial comment accompanying the study underscores the need for additional research to better understand the optimal conditions and approaches for utilizing bariatric surgery in the treatment of obesity-related hypertension.
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The research findings can be found in Journal of the American College of Cardiology.
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