Remission and Relapse of Hypertension After Bariatric Surgery
In around 65–75% of hypertension cases, obesity is one of the primary causes. Over the past two to three decades, the incidence of obesity and complications related to it has doubled globally.
Many studies have stated that bariatric surgery, often called metabolic surgery, is the most effective treatment option for significant weight loss in obese patients. In addition, the efforts of bariatric surgery not only helped to reduce excess weight but also helped in the remission of diabetes and hypertension. Over the last few decades, several weight loss surgeries have been used to treat obesity, but Roux-y gastric bypass (RYGB), mini gastric bypass , and sleeve gastrectomy (SG) are the most widely used surgeries.
According to the 2022 guidelines of the ASMBS and IFSO, patients with a BMI ≥ 35 kg/m2 can opt for bariatric surgery irrespective of the presence of severe obesity-related co-morbidities. Also, bariatric surgery is suggested for patients with a BMI of 30–34.9 kg/m2 and suffering from obesity-related co-morbidities, of which hypertension is one.
Remission (improvement or resolution) and relapse (return of the condition) of hypertension following bariatric surgery
The presence of hypertension in obese patients is linked to it in several ways. Weight loss is one of the most reliable options for hypertension treatment, along with lifestyle changes and medications. Bariatric surgery is one of the best weight loss options and also has positive effects on hypertension in obese individuals. After bariatric surgery, it is observed that there is an immediate decrease in adiposity, improvement in insulin resistance, and reduction in systemic inflammation as a result of weight loss, which all contribute to a decrease in blood pressure.
Experts say that, within a week following bariatric surgery, a reduction in blood pressure can be observed prior to any significant loss of weight.
Though many people experience remission of blood pressure after bariatric surgery, there are chances for relapse. Factors that may contribute to the relapse of hypertension include weight gain, changes in lifestyle that are not adhered to for a long time, and the gradual increase in risk factors for cardiovascular problems with age.
Case study:
Researchers have conducted a study on 787 obese patients (BMI is between 41.4 and 48.7 kg/m2) with hypertension to study the remission and relapse of hypertension following bariatric surgery. Some patients have undergone gastric bypass, and others have undergone sleeve gastrectomy. Reports from the study say that the remission and relapse rates of hypertension were similar in both surgeries. Around 84% remission rates were observed after surgery, and 31.4% of patients regained the conditions after a few years.
How to prevent relapse of hypertension
Management of reduced hypertension in the long term after bariatric surgery frequently requires consistent lifestyle modifications. Making lifestyle changes includes introducing a nutritious diet, getting regular exercise, and taking the medication that the surgeon has prescribed. If any patient fails to maintain these modifications, it may increase the risk of relapse of hypertension.
After bariatric surgery, patients should visit the surgeon regularly so that they can monitor their blood pressure, find relapses or any other complications, and make necessary adjustments to manage the conditions accordingly.
Remember, the results of bariatric surgery vary from one person to another. Hypertension gets resolved over time in some patients, while others might require medication to manage blood pressure even after bariatric surgery.
For more detailed information on how bariatric surgery for weight loss can aid in managing obesity-related complications like diabetes, cardiovascular problems, including blood pressure, and many more. If you are looking for the best bariatric surgeon in Hyderabad, consult Dr. Venugopal Pareek, one of the best weight loss surgeons in Hyderabad. In his career as a bariatric and laparoscopic surgeon, he has done over 550 successful bariatric surgeries in Hyderabad and 9000 laparoscopic surgeries. Call +91 91777 77715 for a doctor’s appointment.
