Research suggests that weight reduction surgery may be a more successful way to control hypertension

Compared to depending only on medicine, bariatric surgery is more successful in treating hypertension, especially in persons with obesity and uncontrolled high blood pressure, according to a new research published in the Journal of the American College of Cardiology. Given the high prevalence of obesity and hypertension in the US, which afflict 41.9% and 45.4% of people, respectively, this conclusion is noteworthy.

An proven risk factor for cardiovascular disease, obesity also contributes significantly to the development of high blood pressure, which raises the possibility of life-threatening illnesses including heart attack, stroke, and heart failure. Lead author and bariatric surgery expert Carlos Aurelio Schiavon, MD, FACS, notes that obesity is a major contributor to cardiovascular risk factors yet is often disregarded in clinical practice.

In this research, patients with obesity and hypertension were compared between the effects of bariatric surgery with medical treatment and medical therapy alone. The findings showed that after five years, patients who had bariatric surgery had a lower BMI and needed fewer prescription drugs to keep their blood pressure levels within normal ranges than others who just took medicine.

The GATEWAY study, which included 100 people with hypertension and a BMI of around 36.9 kg/m2, showed that bariatric surgery patients benefited greatly. The amount of drugs required for these people was reduced by 80.7%, whereas the medication-only group only had a 13.7% drop. Furthermore, compared to only 2.4% in the medication-only group, 46.9% of patients who had bariatric surgery had hypertension remission—defined as stabilized blood pressure without medication.

Although there are still unanswered problems, Michael Hall, MD, MSc, professor and head of the University of Mississippi Medical Center’s Department of Medicine, said the research offers significant long-term evidence on the advantages of gastric bypass surgery for blood pressure management and weight reduction.

“Further studies assessing the threshold for bariatric surgery in people with obesity, optimal timing of bariatric surgery in obese people with cardiometabolic diseases, type of bariatric surgery and comparative studies of obesity pharmacotherapies and bariatric surgery are needed to clarify the optimal treatment pathways for this common and growing disease,” he stated.

Even if the results are encouraging, it is important to recognize the study’s limitations, which include its small sample size, open-label nature, single-centre design, and lack of follow-up in certain patients. However, the research emphasizes how critical it is to treat obesity as a first step in lowering the prevalence of hypertension and decreasing cardiovascular risk factors. To determine the best course of action for treating this prevalent and rapidly expanding illness, further study is required.