- A new study has found that bariatric surgery effectively lowers blood pressure.
- This is important because high blood pressure increases the risk of cardiovascular disease.
- Experts say weight loss improves several factors that influence blood pressure.
- Other steps, such as exercise, stress reduction, and smoking cessation, can also help.
According to new research published in the Journal of the American College of Cardiology, bariatric surgery works better to control high blood pressure in people with obesity than simply taking medication.
At the end of five years, the individuals who had bariatric surgery had a lower body mass index (BMI) and were using fewer medications compared to those who were using blood pressure medications only — while also maintaining normal blood pressure.
These results demonstrate the importance of addressing obesity as a means to reduce high blood pressure and its associated risks, including heart attack, heart failure, and stroke, per the authors.
The lead author of the study, Carlos A. Schiavon, MD, stated that obesity is often overlooked in clinical practice.
“As a consequence, there is a frequent failure in approaching obesity as a crucial step for mitigating the risk of important cardiovascular risk factors, including hypertension,” he said in a press release.
Schiavon and his team decided to look at the impact of treating obesity to reduce elevated blood pressure over the long term.
The trial, called GATEWAY (GAstric bypass to Treat obEse patients With steAdy hYpertension), included 100 people, just over three-quarters of whom were female.
The study participants had a BMI of about 36.9 kg/m2, placing them into the category of
All had high blood pressure, which they were using at least two medications to control.
Each person was randomly assigned to either receive Roux-en-Y gastric bypass with blood pressure medication or blood pressure medication alone.
The study’s stated goal was to reduce the participants’ medication by a minimum of 30% while also keeping blood pressure below a threshold of 140/90 mmHg.
After five years, those who received surgery had a BMI of 28.01 kg/m2, while those who were on medication alone had a BMI of 36.40 kg/m2.
It was also found that those who had received surgery had an 80.7% reduction in how many medications they were using, while those who had received medication had only a 13.7% reduction.
The researchers further found that 46.9% of those who had undergone surgery had complete remission of their high blood pressure and no longer required any medication to keep their blood pressure under control.
Only 2.4% of those in the medication-only group went into remission.
Mir Ali, MD, a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, California, explained that bariatric surgery has the best long-term results for sustained weight loss in people who are qualified to receive it.
“The sustained weight loss has the best effect on reducing blood pressure, improving diabetes and multiple other comorbid conditions,” he said.
“In addition to sustained weight loss having a great effect on reducing blood pressure medications, there are additional metabolic effects that result from bariatric surgery,” Ali added.
Robert Pilchik, MD, a board certified cardiologist with Manhattan Cardiology and a contributor to LabFinder, further explained that the weight loss that occurs due to bariatric surgery has direct and indirect effects that contribute to better blood pressure.
“These include a reduction in arterial stiffness (and thus less pressure within the arteries) by a decreased inflammatory response and improved insulin resistance,” he explained. “Sodium reabsorption is also improved.”
“An increase in gut hormones, such as glucagon-like peptide-1 and peptide YY have beneficial effects on the gastrointestinal system, as well as diuretic and natriuretic effects on the kidneys,” added Pilchik.
Nicole Weinberg, MD, a cardiologist at Providence Saint John’s Health Center in Santa Monica, California, noted that there are several things we can do outside of surgery and medication to help lower blood pressure.
One important step to take is to incorporate more physical activity into your day.
“Exercise is critical to heart health, and it is one of the best ways that you can lower your blood pressure naturally,” said Weinberg.
“Good aerobic exercise can increase your natural nitroglycerin, which is a vasodilating agent. This causes your blood vessels to dilate and lowers your blood pressure,” she explained.
Moderate-intensity exercise like gardening can also be helpful.
“A research study showed that regular gardening cuts stroke and heart attack risk by 30% for patients over 60 years of age,” said Weinberg. She advises gardening on a regular basis for at least 30 minutes at a time.
Weinberg further suggests making sure you have an annual physical.
“Patients that check in with their doctor will be able to have their risk factors of coronary artery disease assessed at this time. If these are assessed at least once a year, then there are less surprises as it relates to these ‘silent killers’,” she stated.
When it comes to diet, Weinberg said the old adage that “you are what you eat” applies.
“If you are eating fried food, sugar beverages, lots of carbs, you are increasing your risks of heart disease, stroke, and diabetes,” she said. “All the medicine in the world cannot counterbalance a terrible lifestyle.”
Ian Kronish, MD, Co-Director,Columbia Hypertension Center, Columbia University Irving Medical Center, said that the two specific diets with the most evidence behind them regarding healthy blood pressure are the DASH diet and the Mediterranean diet.
“[R]educing one’s sodium and alcohol intake, quitting smoking, getting a good night’s sleep, and managing one’s stress can all help,” he added.
Finally, Weinberg remarked that biofeedback can help lower blood pressure. “Biofeedback can be done through regular and consistent meditation,” she suggested. “To derive the benefit of lowered blood pressure, you will need to do meditation approximately 2-3 times a day for 30 minutes at a time.”
A new study has found that people who had bariatric surgery needed fewer medications to maintain healthy blood pressure.
Experts say weight loss provides both direct and indirect effects that help reduce blood pressure.
Controlling blood pressure is important since it can help reduce your risk for outcomes like heart attack, heart failure, and stroke.
In addition to losing weight and taking medications, getting exercise, eating a healthy diet, quitting smoking, getting good sleep, and managing stress are some of the steps you can take to help maintain healthy blood pressure levels.