Metabolic surgery helps reduce cardiac complications in patients with high BP: Study

Hypertension, together with obesity, is a leading cause of mortality and disability. Whilst metabolic surgery offers remission of several metabolic comorbidities, the effect for patients with hypertension remains controversial.

Erik Stenberg at Orebro University and colleagues have found in a new study that metabolic surgeries, such as gastric bypass and gastric sleeve surgery have benefits for people with obesity who have high blood pressure—and can reduce their risk of heart attack, and death. The study has been published in the journal PLOS Medicine.

High blood pressure, particularly when combined with morbid obesity, is a leading cause of death and disability worldwide. Metabolic surgery has been shown to reduce the risk for many conditions that typically accompany obesity, such as type 2 diabetes, high cholesterol and sleep apnea, but it was unclear whether surgery is also effective for treating high blood pressure. To evaluate whether metabolic surgery has benefits for patients with obesity and high blood pressure, the researchers compared two groups of people with these conditions: one that had undergone metabolic surgery, and a control group that hadn't. Individuals in the groups were matched by age, sex and location, and the researchers considered additional factors, such as other health conditions and educational levels. The group that had undergone metabolic surgery had a lower risk of a "major adverse cardiovascular event" such as a stroke, heart attack or cardiac arrest, and they had a lower risk of dying for any reason. Overall, 3.2% of the group that had surgery experienced a major adverse cardiovascular event, compared to 4.5% of the control group.

The new study suggests that metabolic surgery is effective at treating hypertension in individuals with a BMI ≥35kg/m 2. Metabolic surgery may not be a global solution to the obesity epidemic, but with these related conditions causing so much death and disease worldwide, surgery should be considered as an effective option for treating patients with obesity and high blood pressure.

https://doi.org/10.1371/journal.pmed.1003307