Characteristics and resolution of hypertension in obese African American bariatric cohort

Abstract

Weight reduction continues to be first-line therapy in the treatment of hypertension (HTN). However, the long-term effect of bariatric malabsorptive surgical techniques such as Roux-en-Y Gastric Bypass (RYGB) surgery in the management of hypertension (HTN) is less clear. African Americans (AA) are disproportionately affected by obesity and hypertension and have inconsistent outcomes after bariatric surgery (BS). Despite a plethora of bariatric literature, data about characteristics of a predominantly AA bariatric hypertensive cohort including hypertension in obese (HIO) are scarce and underreported. The aims of this study were, (1) to describe the preoperative clinical characteristics of HIO with respect to HTN status and age, and (2) to identify predictors of HTN resolution one year after RYGB surgery in an AA bariatric cohort enrolled at the Howard University Center for Wellness and Weight Loss Surgery (HUCWWS). In the review of 169 AA bariatric patients, the average BMI was 48.50 kg/m2 and the average age was 43.86 years. Obese hypertensive patients were older (46 years vs. 37.89 years; p < .0001); had higher prevalence of diabetes mellitus (DM, 43.09% vs. 10.87%; p < .0001) and dyslipidemia (38.2% vs. 13.04%; p 0.002). Hypertensive AA who were taking ≥ 2 antihypertensive medications prior to RYGB were 18 times less likely to experience HTN resolution compared to hypertensive AA taking 0–1 medications, who showed full or partial response. Also, HIO was less likely to resolve after RYGB surgery in patients who needed ≥ 2 antihypertensive medications prior to surgical intervention.

Effect of Hypertension, Waist-to-Height Ratio, and Their Transitions on the Risk of Type 2 Diabetes Mellitus: Analysis from the China Health and Retirement Longitudinal Study

“…In this sense, Chaudhary et al have shown a strong association of hypertension with all adiposity parameters in T2DM patients [ 39 ]. Gandotra et al have reported that in African American adults with obesity, the prevalence of T2DM in hypertensive patients is eight times as high as that in nonhypertensive individuals [ 45 ]. In line with these results, our current study revealed that HTEW participants are more influential in glucose abnormalities than HTNW and NHEW patients.…”

One Year Follow-up of Laparoscopic Single Anastomosis Sleeve Ileal Bypass in Super-morbidly Obese Patients

“…Concerning the amelioration of comorbid diseases, the resolution of type II diabetes mellitus depended on HbA1c < 6% or fasting blood glucose less than 100 mg/dl in the absence of hypoglycemic drugs [18]. The complete resolution of hypertension was based on blood pressure less than 120/80 without using medications, while its improvement was considered a reduction in dosage or number of anti-hypertensive drugs or systolic and diastolic pressure with the similar drugs [19]. Normal lipid profile after stopping the medications was demarcated as resolved dyslipidemia.…”

Impact of prior bariatric surgery on risk and severity of COVID-19 infection: A meta-analysis of observational studies

“…Bariatric surgery (BS), a sustainable approach to achieving substantial weight loss, not only is beneficial to the cardiovascular system through the modification of cardiometabolic risk factors (e.g., diabetes) and the reduction in major adverse cardiovascular events but also can improve renal functions, alleviate obesity-related inflammation, and enhance patient survival in those with severe obesity [13] , [14] , [15] , [16] , [17] . In addition, patients with obesity who underwent BS were found to have a significantly lower risk of respiratory tract infections compared to those who did not receive the procedure [18] .…”