Laparoscopic Roux-en-Y gastric bypass and its early effect on blood pressure.
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.


CONCLUSIONS
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.
Ahmed
Ahmed R
AR
Division of Bariatric and Gastrointestinal Surgery, University of Rochester Medical Center, Rochester, NY, USA. ahmed_ahmed@urmc.rochester.edu
Rickards
Gretchen
G
Coniglio
Deb
D
Xia
Yinglin
Y
Johnson
Joseph
J
Boss
Thad
T
O'Malley
William
W