Bariatric surgery reduces blood pressure and improves metabolic parameters, suggests study

A new study published in the BMC Cardiovascular Disorders journal showed that bariatric surgery improved metabolic parameters and reduced blood pressure more effectively than non-surgical therapy in hypertensive obese individuals.

Obesity and hypertension together greatly increase the risk of cardiovascular disease and place a heavy strain on health. A "double burden" is placed on the heart by obesity, which raises cardiac output and stroke volume, and hypertension, which raises total peripheral resistance. Pharmacological or surgical therapies, together with weight loss through lifestyle changes, are effective ways to address these diseases.

Maintaining long-term therapy for obesity is still difficult, even if new drugs and lifestyle changes for the condition offer a more optimistic future. This study and meta-analysis assessed how well non-surgical therapies and bariatric surgery worked to control hypertension in obese people.

Up to May 2024, this study looked through databases and included randomized controlled trials (RCTs) that compared non-surgical interventions (such as lifestyle changes and medication) with bariatric surgery (such as Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Gastric Banding (LAGB), Sleeve Gastrectomy (SG), and Duodenal-Jejunal Bypass Liner/Biliopancreatic Diversion (DJBL/BPD) in hypertensive obese patients.

Changes in systolic and diastolic blood pressure were the main results. Changes in lipid profiles, HbA1c, and fasting blood sugar (FBS) were examples of secondary outcomes. A random-effects model was used to synthesize the data, and publication bias and heterogeneity were evaluated.

A total of 29 studies with 2,548 patients out of 7,187 records satisfied the inclusion requirements. When compared to non-surgical measures, bariatric surgery produced larger reductions in both systolic and diastolic blood pressure.

The most notable effect was that of the Roux-en-Y gastric bypass. Additionally, FBS, HbA1c, and triglycerides significantly decreased after bariatric surgery, whereas HDL levels rose. These conclusions were supported by high-quality evidence for the majority of outcomes.

Overall, the results show that bariatric surgery raises HDL levels while dramatically lowering hemoglobin A1C, lipid levels, fasting blood glucose, systolic and diastolic blood pressure, and hemoglobin A1C. Roux-en-Y gastric bypass surgery had the most effect on these results out of all the surgical techniques.

Source:

Dastjerdi, P., Pourfaraji, S. M., Shayesteh, H., Maghsoudi, M., Saeidi, S., Narimani Davani, D., Masouri, M. M., Parhizkar Roudsari, P., Ojaghi Shirmard, F., Ebrahimi, P., Farooqi, M. A., Hosseini, K., & Soleimani, H. (2025). The role of bariatric surgery in hypertension control: a systematic review and meta-analysis with extended benefits on metabolic factors. BMC Cardiovascular Disorders, 25(1), 213. https://doi.org/10.1186/s12872-025-04640-9