Gastroenterologie
a hepatologie

Obesity and hypertension: recommending challenging bariatric surgery in hypertensive patients?

Emilija Dameski¹

+ Affiliation
¹ Centrum pro léčbu obezity a metabolických poruch, OB KLINIKA, a. s., Praha

Summary

The long-known relationship between obesity and a significant increase in cardiovascular diseases, including hypertension, is well established. The prevalence of hypertension increases proportionally with rising body weight and represents a significant factor in the connection between obesity and mortality from cardiovascular diseases. It has been demonstrated that even within a normal BMI range, an increase in weight leads to a corresponding rise in blood pressure. The main mechanisms by which obesity negatively affects blood pressure include increased blood volume, changes in the vascular system, activation of the renin-angiotensin system, insulin resistance, inflammatory processes, and sleep apnea. In this case study, we aim to demonstrate the effect of bariatric surgery, specifically gastric plication, on the course of hypertension. The case study shows that bariatric surgery in a patient with class I obesity and poorly controlled hypertension led to a significant reduction in body weight and also contributed to a decrease in polypharmacy.

Keywords

To read this article in full, please register for free on this website.

Benefits for subscribers

Benefits for logged users

Literature

1. Fried M. Léčba obézního hypertonika chirurgickou cestou. 2008 [online]. Dostupné z: https: //www.tribune.cz/archiv/lecba-obezniho-hypertonika-chirurgickou-cestou/.
2. Kloock S, Ziegler CG, Dischinger U. Obesity and its comorbidities, current treatment options and future perspectives: Challenging bariatric surgery? Pharmacol Ther 2023; 251: 108549. doi: 10.1016/j.pharmthera.2023.108549.
3. Murray CJ, Aravkin AY, Zheng P et al. Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet 2020; 396(10258): 1223–1249. doi: 10.1016/S0140-6736(20)30752-2.
4. Wohlfahrt P. Jak přistupovat k léčbě arteriální hypertenze u pacienta s obezitou. Med Praxi 2022; 19(1): 35–38. doi: 10.36290/med.2022.005.
5. Pelikánová T. Inzulinová rezistence a metabolický syndrom. Int Med 2003; 5(10): 491–495.
6. Mancusi C, Izzo R, di Gioia et al. Insulin Resistance the Hinge Between Hypertension and Type 2 Diabetes. High Blood Press Cardiovasc Prev 2020; 27(6): 515–526. doi: 10.1007/s40292-020-00408-8.
7. Higgins M, Kannel W, Garrison R et al. Hazards of obesity – the Framingham experience. Acta Med Scand Suppl 1988; 723: 23–36. doi: 10.1111/j.0954-6820.1987.tb05925.x.
8. Krauss RM, Winston M, Fletcher RN et al. Obesity: impact of cardiovascular disease. Circulation 1998; 98(14): 1472–1476.
9. Kelly T, Yang W, Chen CS et al. Global burden of obesity in 2005 and projections to 2030. Int J Obes 2008; 32(9): 1431–1437. doi: 10.1038/ijo.2008.102.
10. Dansinger ML, Tatsioni A, Wong JB et al. Meta-analysis: the effect of dietary counseling for weight loss. Ann Intern Med 2007; 147(1): 41–50. doi: 10.7326/0003-4819-147-1-200707030-00007.
11. Sjöström L, Lindroos AK, Peltonen et al. Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 2004; 351(26): 2683–2693. doi: 10.1056/NEJMoa035622.
12. Buchwald H, Avidor Y, Braunwald E et al. Bariatric surgery: a systematic review and meta-analysis. JAMA 2004; 292(14): 1724–1737. doi: 10.1001/jama.292.14.1724.
13. Schiavon CA, Cavalcanti AB, Oliveira JD et al. Randomized trial of effect of bariatric surgery on blood pressure after 5 years. J Am Coll Cardiol 2024; 83(6): 637–648. doi: 10.1016/j.jacc.2023.11.032.
14. Eisenberg D, Shikora SA, Aarts E et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): indications for metabolic and bariatric surgery. Surg Obes Relat Dis 2022; 18(12): 1345–1356. doi: 10.1016/j.soard.2022.08.013.