Predictors of Hypertension Remission and Recurrence After Bariatric Surgery.
BACKGROUND
Few data exist on factors associated with hypertension (HTN) remission post-bariatric surgery. No information on factors that may predict HTN relapse is available. The aims were to assess the HTN remission and relapse rates at 1 and 3 years, respectively, post-bariatric surgery, and determine predictive factors.


METHODS
A nonrandomized prospective cohort study on severely obese patients undergoing laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) with a follow-up of 36 months was conducted between 2005 and 2011. Criteria for HTN diagnosis were current treatment with antihypertensive agents and/or systolic blood pressure (BP) >140 mm Hg and/or diastolic BP >90 mm Hg. HTN remission was defined as normalization of BP maintained after discontinuation of medical treatment.


RESULTS
A total of 197 patients were included in the study. HTN was present in 47.7%; 68.1% of hypertensive patients showed HTN remission 1 year after the surgical procedure, 21.9% of whom had relapsed at 3 years. The number of antihypertensive drugs prior to surgery was associated with a lower remission rate at the first year and a higher recurrence at 3 years. However, a smaller weight loss during the first year was associated with increased HTN recurrence at 3 years.


CONCLUSIONS
HTN relapses in 1 of 5 hypertensives who have achieved remission at the first year of follow-up. Weight loss during the first postoperative year should be encouraged to avoid HTN relapse at 3 years.
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; 96002@parcdesalutmar.cat.
David
D
Benaiges
Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain;
María
M
Sagué
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain;
Juana A
JA
Flores-Le Roux
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain;
Juan
J
Pedro-Botet
Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Department of General Surgery, Hospital del Mar, Barcelona, Spain;
José M
JM
Ramón
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain;
Montserrat
M
Villatoro
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain;
Juan J
JJ
Chillarón
Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Department of General Surgery, Hospital del Mar, Barcelona, Spain;
Manuel
M
Pera
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain;
Antonio
A
Más
Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; Department of General Surgery, Hospital del Mar, Barcelona, Spain;
Luis
L
Grande
Department of Endocrinology and Nutrition, Hospital del Mar, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain; CiberOBN, Instituto de Salud Carlos III, Santiago de Compostela, Spain.
Albert
A
Goday
D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D004359:Drug Therapy, Combination; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
D000959:Antihypertensive Agents
bariatric surgery; blood pressure; gastric bypass; hypertension; morbid obesity.; sleeve gastrectomy