Can gastric by-pass surgery improve blood pressure variability in patients with hypertension?

This study investigated if bariatric (gastric bypass) surgery (BS) improves blood pressure variability (BPV) in resistant hypertension (RH). They found that BS improves blood pressure control in RH. 

Hypertension or high blood pressure (BP) is a common and serious condition. Resistant hypertension (RH) occurs when BP cannot be controlled using medication. Patients with RH are usually prescribed several drugs to reduce BP. These drugs are called anti-hypertensives (AHTs). Patients with RH will usually take several AHTs at high doses to try and control BP. 

RH is more common in patients that are also obese. Bariatric or gastric bypass surgery (BS) is used to treat RH in these patients. BS involves by-passing the stomach. This reduces the capacity of the stomach. BS can improve weight loss in obese patients. Studies show that it can also reduce BP. These studies usually measure BP at doctor’s visits. It is unclear if BS improves BP control in daily life. 

This study included 100 patients with RH. Patients were defined as obese if their body mass index (BMI) was greater than 30. BP was measured at the start of the trial. Patients were randomly assigned to undergo BS in addition to AHTs or AHTs alone. Patients were asked to wear 24-hour BP monitors during the study. Follow-up was performed at 12 months. BP levels were assessed for variability (BPV).

24-hour BP control was similar in both groups at 12 months. Patients that underwent BS required less AHT treatment at 12 months. Nighttime BPV was reduced in BS patients. The occurrence of RH was significantly lower in patients that underwent BS compared to those treated with AHTs alone (0% vs 14%).

The authors concluded that BS improves blood pressure control in RH. 

This study did not measure if patients took their medication correctly. This could impact the results.

If you have any concerns regarding hypertension treatment, please consult with your physician.