Laparoscopic Roux-en-Y Gastric Bypass and Its Early Effect on Blood Pressure

Background  Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is known to have a significant effect on obesity-related comorbidities such as hypertension curing it in some (50–70%) while improving control in others. Our aim was to observe the changes in blood pressure (BP) in a cohort of 100 patients followed prospectively for 1 year after LRYGB. Methods  BP measurements were recorded prospectively in 100 consecutive patients preoperatively and then postoperatively at weeks 1, 5, 9, and months 6 and 12. In order to reduce bias, three BP measurements were made by the same nurse at each office visit and the mean recorded. Pre- and postoperative usage of antihypertensive medication was also noted. Results  Eighty-nine women and 11 men underwent LRYGB and their BP monitored for 1 year. There was an 85% follow-up rate with mean % excess body weight loss of 60. Reductions in systolic (9 mmHg) and diastolic (7 mmHg) BP measurements were seen as early as week 1 postoperatively and maintained for the duration of the observation period (P < 0.05). Furthermore, postoperative usage of antihypertensive medication is reduced to a third of preoperative use. Conclusion  LRYGB is associated with an early reduction in BP and antihypertensive medication usage which is maintained at 1 year after surgery. This early impact on blood pressure occurs before any significant weight loss is achieved thereby suggesting a hormonal mechanism that may be involved for the changes observed. Presented in part at the Annual Scientific Session of the American Society of Metabolic and Bariatric Surgery, San Diego, CA, June 13–17, 2007.