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Comparison of hypertension remission and relapse after sleeve gastrectomy and one-anastomosis gastric bypass: a prospective cohort study

Hypertension Research volume 46, pages 1287–1296 (2023)Cite this article

Abstract

This study aimed to assess the remission and relapse of hypertension (HTN) in hypertensive individuals who underwent sleeve gastrectomy (SG) and one-anastomosis gastric bypass (OAGB) and identify the predictors of HTN remission and relapse following bariatric surgery. A prospective cohort study with a follow-up of 3 years was conducted on severely obese patients between 2013 and 2018. Hypertension remission was defined as the normalization of blood pressure (BP) with the discontinuation of medical treatment, and HTN relapse was defined as the need for the onset of antihypertensive drugs or the occurrence of BP impairment. A total of 787 hypertensive patients were included in this study. The cumulative incidence of HTN remission and relapse were 83.9% (95% CI: 81.6–86.5) and 31.4% (95% CI: 25.6–38.2), respectively. Remission and relapse were not significantly different among the patients undergoing either surgery (SG or OAGB). A higher remission rate was linked to a younger age and the use of fewer antihypertensive medications pre-operation. However, failure to successfully lose weight during the first year postoperative and weight regain predicted a higher risk of HTN relapse after 3 years. Following bariatric surgery, BP drops initially but then gradually rises. These alterations are responsible for about 31% relapse after 3 years in those who initially achieve remission. Patients who are younger and use less antihypertensive medications before surgery may benefit the most from bariatric surgery in terms of HTN. First-year successful weight loss and control of weight regain may prevent HTN relapse in the following years.

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Data availability

The datasets used and analyzed in the current study are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to thank the hospital staff, assistants, and coordinators who took part in this research. Also, special thanks to Mohammadreza Golsibi for his assistance and support in working with the electronic patient data system.

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Authors and Affiliations

  1. Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Amir Ebadinejad, Mahbod Shahshahani, Farhad Hosseinpanah, Faranak Ghazy, Maryam Mahdavi, Majid Valizadeh & Maryam Barzin

  2. Tehran Obesity Treatment Center, Department of Surgery, Faculty of Medicine, Shahed University, Tehran, Iran

    Alireza Khalaj

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Contributions

AE: study design, data collection, coordination of patients’ issues, manuscript preparation, and final approval of the manuscript. MS: data collection, literature review, and manuscript preparation. FH: data collection, literature review, and manuscript preparation. AK: study design, performing surgical operations, and final approval of the manuscript. MM: data analysis, data interpretation, and manuscript preparation. FG: data collection, literature review, and manuscript preparation. MV: final approval of the manuscript. MB: study design, revising the manuscript, and final approval of the manuscript. All authors reviewed and approved the final draft of the manuscript.

Corresponding author

Correspondence to Maryam Barzin.

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All the procedures performed in the study were approved by the Research Ethics Committee of the Research Institute for Endocrine Sciences of Shahid Beheshti University of Medical Sciences and were in accordance with the ethical standards of the institutional Human Research Review Committee (IR.SBMU.ENDOCRINE.REC.1400.096) and the 1964 Helsinki declaration and its later amendments. Informed written consent was obtained from all participants.

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Ebadinejad, A., Shahshahani, M., Hosseinpanah, F. et al. Comparison of hypertension remission and relapse after sleeve gastrectomy and one-anastomosis gastric bypass: a prospective cohort study. Hypertens Res 46, 1287–1296 (2023). https://doi.org/10.1038/s41440-023-01180-7

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