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Obesity Surgery
Published in: Obesity Surgery 7/2009

01-07-2009 | Research Article

Laparoscopic Roux-en-Y Gastric Bypass and Its Early Effect on Blood Pressure

Authors: Ahmed R. Ahmed, Gretchen Rickards, Deb Coniglio, Yinglin Xia, Joseph Johnson, Thad Boss, William O’Malley

Published in: Obesity Surgery | Issue 7/2009

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Abstract

Background

Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is known to have a significant effect on obesity-related comorbidities such as hypertension curing it in some (50–70%) while improving control in others. Our aim was to observe the changes in blood pressure (BP) in a cohort of 100 patients followed prospectively for 1 year after LRYGB.

Methods

BP measurements were recorded prospectively in 100 consecutive patients preoperatively and then postoperatively at weeks 1, 5, 9, and months 6 and 12. In order to reduce bias, three BP measurements were made by the same nurse at each office visit and the mean recorded. Pre- and postoperative usage of antihypertensive medication was also noted.

Results

Eighty-nine women and 11 men underwent LRYGB and their BP monitored for 1 year. There was an 85% follow-up rate with mean % excess body weight loss of 60. Reductions in systolic (9 mmHg) and diastolic (7 mmHg) BP measurements were seen as early as week 1 postoperatively and maintained for the duration of the observation period (P < 0.05). Furthermore, postoperative usage of antihypertensive medication is reduced to a third of preoperative use.

Conclusion

LRYGB is associated with an early reduction in BP and antihypertensive medication usage which is maintained at 1 year after surgery. This early impact on blood pressure occurs before any significant weight loss is achieved thereby suggesting a hormonal mechanism that may be involved for the changes observed.
Literature
1.
Adams TD, Gress RE, Smith SC et al (2007) Long-term mortality after gastric bypass surgery. N Engl J Med 357:753–61CrossRef
2.
Sjöström L, Narbro K, Sjöström CD et al (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357:741–52CrossRef
3.
Must A, Spadano J, Coakley EH et al (1999) The disease burden associated with overweight and obesity. JAMA 282:1523–9CrossRef
4.
Goldstein DJ (1992) Beneficial health-effects of modest weight loss. Int J Obes 16:397–415
5.
Buchwald H, Avidor Y, Braunwald E et al (2004) Bariatric surgery. A systematic review and meta-analysis. JAMA 292 14:1728, OctCrossRef
6.
Fazylov R, Soto E, Merola S (2008) Laparoscopic Roux-en-Y gastric bypass in morbidly obese patients >/=55 years old. Obes Surg 18:656–9, Apr 12CrossRef
7.
Fernstrom J, Courcoulas A, Houck P et al (2006) Long-term changes in blood pressure in extremely obese patients who have undergone bariatric surgery. Arch Surg 141:276–283CrossRef
8.
Carson JL, Ruddy ME, Duff AE et al (1994) The effect of gastric bypass surgery on hypertension in morbidly obese patients [published erratum appears in Arch Intern Med 1994 Aug 8;154 15:1770]. Arch Intern Med 154:193–200CrossRef
9.
Reinhold RB (1994) Late results of gastric bypass surgery for morbid obesity [see comments]. J Am Coll Nutr 13:326–31CrossRef
10.
Foley EF, Benotti PN, Borlase BC et al (1992) Impact of gastric restrictive surgery on hypertension in the morbidly obese. Am J Surg 163:294–7CrossRef
11.
Sugerman HJ, Wolfe LG, Sica DA et al (2003) Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg 237:751–6PubMedPubMedCentral
12.
Czupryniak L, Strzelczyk J, Pawlowski M et al (2005) Circadian blood pressure variation in morbidly obese hypertensive patients undergoing gastric bypass surgery. AJH 18:446–51PubMed
13.
Pories WJ, Swanstrom MS, MacDonald KG et al (1995) Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Am Surg 222:339–50
14.
Husain S, Ahmed AR, Johnson J et al (2007) Small-bowel obstruction after laparoscopic Roux-en-Y gastric bypass: etiology, diagnosis, and management. Arch Surg 142 10:988–93CrossRef
15.
Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC report. JAMA 289:2560–72CrossRef
16.
Sjostrom L, Lindroos AK, Peltonen M et al (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351:2683–93CrossRef
17.
Cunneen SA, Phillips E, Fielding G et al (2008) Studies of Swedish adjustable gastric band and Lap-Band: systematic review and meta-analysis. Surg Obes Relat Dis 4 2:174–85CrossRef
18.
Aggarwal S, Kini SU, Herron DM (2007) Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis 3 2:189–94CrossRef
19.
Gagner M, Matteotti R (2005) Laparoscopic biliopancreatic diversion with duodenal switch. Surg Clin North Am 85 1:141–9CrossRef
20.
Sjostrom CD, Peltonen M, Wedel H et al (2000) Differentiated long-term effects of intentional weight loss on diabetes and hypertension. Hypertension 36:20–5CrossRef
21.
Clements RH, Gonzalez QH, Long CI et al (2004) Hormonal changes after Roux-en-Y gastric bypass for morbid obesity and the control of type II diabetes mellitus. Am Surg 70:1–4PubMed
22.
Yamamoto H, Kishi T, Lee C et al (2003) Glucagon-like peptide-1-responsive catecholamine neurons in the area postrema link peripheral glucagon-like peptide-1 with central autonomic control sites. J Neurosci 23 7:2939–46CrossRef
23.
Gutzwiller JP, Tschopp S, Bock A et al (2004) Glucagon-like peptide 1 induces natriuresis in healthy subjects and in insulin-resistant obese men. J Clin Endocrinol Metab 89 6:3055–61CrossRef
24.
Ruano M, Silvestre V, Castro R et al (2005) Morbid obesity, hypertensive disease and the rennin–angiotensin–aldosterone axis. Obes Surg 15 5:670–6CrossRef
25.
Pickering TG (1994) Blood pressure measurement and detection of hypertension. Lancet 344:31–5CrossRef
26.
Livingston E (2005) Treating obesity-related hypertension with surgery. AJH 18:443–5PubMed
27.
Sugerman HJ, Kellum JM Jr, DeMaria EJ et al (1996) Conversion of failed or complicated vertical banded gastroplasty to gastric bypass in morbid obesity. Am J Surg 171:263–9CrossRef
Metadata
Title
Laparoscopic Roux-en-Y Gastric Bypass and Its Early Effect on Blood Pressure
Authors
Ahmed R. Ahmed
Gretchen Rickards
Deb Coniglio
Yinglin Xia
Joseph Johnson
Thad Boss
William O’Malley
Publication date
01-07-2009
Publisher
Springer New York
Published in
Obesity Surgery / Issue 7/2009
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-008-9671-z

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