A new study shows that bariatric surgery is more effective at controlling high blood pressure in people with obesity than medication alone.
Published in the Journal of the American College of Cardiology, the study followed participants for five years and found that those who underwent bariatric surgery had better blood pressure control, lost more weight, and took fewer medications.
According to the CDC, 41.9% of U.S. adults are obese and 45.4% have hypertension.
Obesity is a major risk factor for cardiovascular disease, which includes heart attacks, strokes, and heart failure. Treating obesity can be a key step in managing high blood pressure.
The GATEWAY trial included 100 participants with an average BMI of 36.9 kg/m². All had uncontrolled hypertension and were using at least two medications.
Participants were randomly assigned to either Roux-en-Y gastric bypass surgery plus medication or medication alone.
The goal was to reduce medication use by 30% while maintaining blood pressure below 140/90 mmHg over five years.
After five years, people who had bariatric surgery had a BMI of 28.0 compared to 36.4 in the medication-only group. The surgery group reduced their use of blood pressure medications by 80.7%, compared to just 13.7% in the medication group.
Almost 47% of people in the surgery group no longer needed any medication to control their blood pressure, compared to only 2.4% in the other group.
Dr. Carlos Schiavon, the lead author and a bariatric surgeon in Sao Paulo, emphasized the importance of addressing obesity as a first step in controlling hypertension.
In an editorial comment, Dr. Michael Hall from the University of Mississippi Medical Center said that although the results are promising, more studies are needed to define the best time for surgery and compare it with new obesity medications.
The study had some limitations: it was conducted at a single center, was open-label (meaning participants knew which treatment they received), and had a small sample size with some loss of follow-up over time.
This study supports the use of bariatric surgery as a powerful tool in managing obesity and controlling high blood pressure, potentially reducing the need for long-term medication.
As obesity and hypertension rates continue to rise, these findings could influence future treatment strategies.
The study is published in Journal of the American College of Cardiology.
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