Arterial Hypertension in Morbid Obesity after Bariatric Surgery: Five Years of Follow-Up, a Before-And-After Study

Abstract

Background: Arterial hypertension (HTN) is common among morbidly obese patients undergoing bariatric surgery. The aim of this study is to analyse the prevalence and evolution of HTN and weight loss in patients suffering from morbid obesity before and after bariatric surgery, during a follow-up period of five years. Methods: A before-and-after study was carried out on severely obese patients undergoing Laparoscopic Roux-En-Y Gastric Bypass (LRYGB). Criteria for HTN diagnosis were current treatment with antihypertensive agents and/or systolic blood pressure (SBP) >140 mm Hg and/or diastolic (DBP) > 90 mm Hg. HTN remission was defined as normalisation of blood pressure (BP) maintained after discontinuation of medical treatment, and HTN recurrence was considered when HTN diagnostic criteria reappeared after remission. Weight loss during the study period was evaluated for each patient, calculating excess weight loss percentage (% EWL) and BMI loss percentage (% BMIL) with reference to the baseline value. Results: A total of 273 patients were included in the study. HTN was present in 48.2%; 29.4% of hypertensive patients showed HTN remission two years after the surgical procedure, 30.3% of them had relapsed at five years. Conclusion: LRYGB in obese patients is associated with a remission of HTN, and no weight loss differences were observed between the group of patients showing HTN remission at two years and the group who did not. However, differences were observed after the second follow-up year, with an increased weight loss in the remission group, which could indicate that sustained weight loss favours the control of HTN.

The correlation between body weight, serotonin levels, mental health status, sleep disorders and metabolism in patients with obesity

“…The dependence between BMI with a significant number of indicators and indices on it was proved. The results of our study confirmed the highly correlated positive dependence of BMI and WC, HC, calculated indices of abdominal obesity BSA, WHR, ConI, ABSI, AVI in patients with obesity of the first and second degree, which coincides with the data of M. Gažarová et al Blood pressure levels and lipid metabolism indicators correlated with BMI, which confirms the data K. Foti et al [26], W. Zhang [27], A. Arias et al [28], who noted the presence of such connections in their research. Although this dependence is controversial in the general population, given the research by D. Højland Ipsen et al [29], there is the presence of lipid metabolism disorders in patients with normal BMI as well.…”

Factors associated with hypertension remission after gastrectomy for gastric cancer patients

“…The molecular mechanism of hypertension remission after gastrectomy for gastric cancer patients is unclear, but it might be related to bariatric surgery for obese patients[ 29 , 30 ]. There were many possible molecular mechanisms of hypertension remission for obese patients after bariatric surgery: elevated activation of the renin–angiotensin–aldosterone system in obese patients might normalize after surgery[ 31 ] and the improvement of gastrointestinal gut hormone levels and insulin resistance after surgery[ 32 ], a possible effect of these gut hormones on the sympathetic nervous system[ 33 ], adipokines and other inflammatory cytokines would lead to hypertension recovery[ 34 ].…”

Characterization and Outcomes of SARS-CoV-2 Infection in Overweight and Obese Patients: A Dynamic Comparison of COVID-19 Pandemic Waves

“…Several comorbidities have been studied in relationship with severe COVID-19, and it was observed than 25% of hospitalized patients and approximately three quarters of ICU patients with SARS-CoV-2 had at least one comorbid condition [ 22 , 23 ]. Comorbidities such as hypertension, cardiovascular disease, and diabetes mellitus were the most common and often mentioned in reports around the world [ 24 , 25 ], and all are known to be connected with obesity, and indeed, obesity is increasingly recognized as both a comorbidity and a risk factor [ 26 , 27 ]. Obesity prevalence rises with age in both men and women, having significant consequences for global health, since excess weight, as measured by an elevated body mass index (BMI), affects a large proportion of the world’s population, with almost 40% being overweight, and more than 10% obese [ 28 ].…”