Remission and Relapse of Hypertension After Bariatric Surgery: A Retrospective Study on Long-Term Outcomes

Autor: David P. Fisher, MD, Liyan Liu, MD, MS, David Arterburn, MD, Karen J. Coleman, PhD, Anita Courcoulas, MD, MPH, Sebastien Haneuse, PhD, Eric Johnson, MS, Robert A. Li, MD, Mary Kay Theis, MS, Brianna Taylor, MPH, Heidi Fischer, PhD, Julie Cooper, MPA, Lisa J. Herrinton, PhD
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Zdroj: Annals of Surgery Open, Vol 3, Iss 2, p e158 (2022)
Druh dokumentu: article
ISSN: 2691-3593
00000000
DOI: 10.1097/AS9.0000000000000158
Popis: Objectives:. To compare hypertension remission and relapse after bariatric surgery compared with usual care. Background:. The effect of Roux-en-Y gastric bypass and sleeve gastrectomy on hypertension remission and relapse has not been studied in large, multicenter studies over long periods and using clinical blood pressure (BP) measurements. Methods:. This retrospective cohort study was set in Kaiser Permanente Washington, Northern California, and Southern California. Participants included 9432 patients with hypertension 21–65 years old who underwent bariatric surgery during 2005–2015 and 66,651 nonsurgical controls matched on an index date on study site, age, sex, race/ethnicity, body mass index, comorbidity burden, diabetes status, diastolic and systolic BP, and number of antihypertensive medications. Results:. At 5 years, the unadjusted cumulative incidence of hypertension remission was 60% (95% confidence interval [CI], 58–61%) among surgery patients and 14% (95% CI, 13–14%) among controls. At 1 year, the adjusted hazard ratio for the association of bariatric surgery with hypertension remission was 10.24 (95% CI, 9.61–10.90). At 5 years, the adjusted hazard ratio was 2.10 (95% CI, 1.57–2.80). Among those who remitted, the unadjusted cumulative incidence of relapse at 5 years after remission was 54% (95% CI, 51–56%) among surgery patients and 78% (95% CI 76–79%) among controls, although the adjusted hazard ratio was not significant (hazard ratio, 0.71; 95% CI, 0.46–1.08). Conclusions:. Bariatric surgery was associated with greater hypertension remission than usual care suggesting that bariatric surgery should be discussed with patients with severe obesity and hypertension. Surgical patients who experience remission should be monitored carefully for hypertension relapse.
Databáze: Directory of Open Access Journals
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