Abstract
Aim
Bariatric surgery is gradually becoming a surgical field of paramount importance to global health. Our aim is to assess the performance of RYGB and SG in achieving remission of hypertension in bariatric patients. Secondarily, we aim to assess how age, gender, referral BMI, severity of hypertension, and association with T2DM, affects hypertension remission rates.
Method
In this observational, retrospective cohort study, we included 475 out of 505 total bariatric patients operated at the Worcestershire Royal Hospital between 2012 and 2019. Overall, 193 patients (40.6%) where taking anti-hypertensive medications pre-operatively. Hypertensive patients were divided into three categories: Mild (1 anti-hypertensive medication) 44%, moderate (2 anti-hypertensive medications) 39%, and severe (3 or more anti-hypertensive medications) 17%. All patients underwent either a RYGB 52% (101/193) or a SG 48% (92/193). We assessed hypertension remission after 1 and after 2 years.
Results
Hypertension remission rates post-RYGB where 40.0% after 1 year (38/95), and 43.0% (34/79) after 2 years. Rates post-SG where 40.8% after 1 year (31/76) and 43.1% (22/51) after 2 years. There was no statistically significant difference in hypertension remission rates between RYGB and SG, nor with any of secondary variable, including gender, age, BMI, severity of hypertension and association with T2DM.
Conclusions
Our data showed no significant difference between RYGB and SG in hypertension remission rates after 1- and 2-years post-procedure. This provides novel insights into the risk-benefit assessment of the bariatric patient, and helps define the SG as a much simpler, cheaper and safer surgical option for bariatric patients with hypertension as their major co-morbidity.