title: Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease.
abstract: This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery.Wilcoxon signed-ranks test was used for the statistical analyses. Seventy GERD patients were included in the analysis and followed up for a mean period of 3.5 ± 1.4 years. Prior to surgery, all participating patients were taking at least one class of antihypertensive medication, and 56 patients (80%) had intermittently high blood pressure. After surgery, the mean number of antihypertensive medication classes per patient was significantly reduced from 1.61 ± 0.77 pre-procedure to 1.27 ± 0.88 post-procedure (P < 0.001). The blood pressure of 48 of the 56 cases (86%) with preoperative intermittent high blood pressure returned to normal post procedure. A total of 50 patients (71%) recorded improvements on the hypertension control scale, with the overall mean score decreasing from 3.1 ± 1.0 preprocedure to 1.4 ± 1.0 post-procedure (P < 0.001). Therefore, successful laparoscopic fundoplication may result in better blood pressure control in some hypertensive GERD patients. This result suggests a possible connection between gastroesophageal reflux and hypertension.
authors.affiliation: Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Hu
authors.affiliation: Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China.
authors.forename: Meiping
authors.initials: M
authors.lastname: Chen
authors.affiliation: Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China.
authors.forename: Jimin
authors.initials: J
authors.lastname: Wu
authors.affiliation: Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Song
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
authors.forename: Chao
authors.initials: C
authors.lastname: Yan
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Du
authors.affiliation: Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, 100088, China. zhonggaowang@126.com.|Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China. zhonggaowang@126.com.
authors.forename: Zhonggao
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D002681:China; D005260:Female; D018662:Fundoplication / Q000295:instrumentation*; D005764:Gastroesophageal Reflux / Q000150:complications* / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents
keywords: blood pressure; gastroesophageal reflux disease; hypertension; laparoscopic fundoplication