Obesity Surgery May Cut Hypertension

CNN.com
Wednesday, March 22, 2006

CHICAGO, Illinois (Reuters) — Weight loss surgery has the added benefit of dropping high blood pressure levels as it slims morbidly obese patients, according to a new study.

Patients who had not been taking drugs to treat their hypertension prior to surgery saw a significant easing of their blood pressure afterward, and some of those on antihypertension drugs were able to stop taking them, according to research published Monday in the Archives of Surgery.

Roughly two-thirds of morbidly obese people have high blood pressure, which is considered a prime risk factor for heart attacks and strokes, the report said. Obese people who take weight off can also lower the associated risks of ailments such as diabetes, some cancers and joint stress.

The study tracked 347 severely obese patients who had gastric bypass surgery at the University of Pittsburgh Medical Center from 1992 to 2001. Half had high blood pressure, with some 100 taking drugs to treat it.

Eighteen months after the surgery, which often involves shrinking the stomach and bypassing the nutrient-absorbing large intestine, the patients’ weight had stabilized at around a body mass index of 35 — a level at which someone is considered moderately obese.

A person’s body mass index is a ratio of height and weight, with a figure 30 or above considered obese and 40 or more morbidly obese.

Long-term benefitsAfter surgery, patients who had not been undergoing drug treatment for hypertension experienced a modest decrease in their systolic blood pressure — the higher reading taken when the heart contracts — and a significant decrease in diastolic pressure — the lower figure when the heart is at rest.

Among those who had been taking blood pressure drugs, one-third were able to stop taking them and others lowered their dosages.

“In counseling patients who are considering gastric bypass surgery, this study will help us to identify those patients who can reasonably expect the long-lasting health benefits from significantly reduced blood pressure,” said study co-author Madelyn Fernstrom, an associate professor of psychiatry, epidemiology and surgery at the University of Pittsburgh.

“It also is important to note that blood pressure reductions occurred in patients even though they remained obese with (a body mass index) in the 35 range, which is still not ideal, further suggesting that weight loss itself — in this study, achieved through gastric bypass surgery — can improve health outcomes,” Fernstrom said.

Weight-loss surgery is booming in the United States, doubling to 140,000 operations in 2004 compared to two years earlier, with an estimated 2 percent of the U.S. population morbidly obese. The death rate from complications after surgery ranges from 0.5 percent to 1 percent of patients.

Tags: lap band, gastric bypass, bariatric surgery, weight loss surgery, obesity surgery, lapband, sleep apnea, high blood pressure, hypertension