Importance of Metabolic Surgery to Improve BP Control in Obesity

Obesity and overweight is increasingly becoming a source of concern for societies and health systems in various countries. This is fueled by the increasing appetite for junk foods, sedentary lifestyles and a lack of exercise. Obesity has grave medical implications as it heightens the risk of cardiovascular disease, dyslipidemia, type 2 diabetes Mellitus, arthritis and other long term deleterious effects. Obesity in associated with dyslipidemia, hypertension, type 2 diabetes Mellitus make up the clinical entity called metabolic syndrome. Hypertension is a potent risk factor for major cardiovascular events such as strokes, myocardial infarction etc.

Traditional management of hypertension has relied on the use of anti-hypertensive medications and lifestyle modifications. Management for obesity has included lifestyle modifications such as exercise, dieting, and drugs. The results achieved with the use of these interventions has been frustratingly abysmal.

Metabolic surgery currently is the most effective method for achieving rapid weight loss in individuals who meet the criteria. Metabolic surgery makes use of bariatric techniques such as ileal interposition, transit bipartition, sleeve gastrectomy etc. This surgery is also called diabetes surgery, weight loss surgery or metabolic surgery.

Apart from the rapid attainment and maintenance of weight loss, it has been discovered that metabolic surgery in the long term also leads to improvement in co-morbidities such as Type 2 Diabetes Mellitus, dyslipidemia and even hypertension, hence the name metabolic surgery.

The biggest evidence as yet which points to the fact that obese individuals who undergo this surgery have better control over their blood pressure comes from the GATEWAY study. The study monitored 100 patients with hypertension whose BMI ranged between 30 – 39 kg/m2. It was discovered from the study that individuals who underwent surgery attained faster control of the blood pressure in 12 months (83%) compared to those who relied solely on anti-hypertensive medications (12.8%). This is revealing and a pointer to the fact that obese individuals who undergo metabolic surgery have a better control of their blood pressure in addition to improvement of other obesity-associated co-morbidities.

This can be explored as a strategy in the management of hypertension in obese individuals who will both benefit from rapid weight loss and improvement in blood pressure control.

Current approach to hypertension management includes use of multiple anti-hypertensive pills, dietary and lifestyle modifications. This has been associated with poor compliance and medication fatigue. This negatively affects treatment success.

With the use of Metabolic surgery, obese individuals who are also hypertensive will not only benefit from rapid weight loss but will have better blood pressure control with the use of less anti-hypertensive medications. Thus, thus is a valuable treatment modality and benefit of Metabolic surgery. It should however be noted that not all individuals qualify for metabolic surgery. Discuss with your physician on your eligibility today.