637 Can Metabolic Surgery Lead to Hypertension Remission? Our Experience

Aim

To evaluate the rate of remission (RR) from hypertension after Laparoscopic Roux-en-y Gastric Bypass (LRYGB) and Laparoscopic Sleeve Gastrectomy and determine any difference between the groups.

To analyse if the patient’s age, sex, BMI and number of anti-hypertensive medications (AHMs) taken preoperatively affected remission after surgery.

Method

Retrospective cohort analysis of all patients on AHMs who had undergone LRYGB or LSG as their primary procedure at Worcestershire Royal Hospital (WRH) between 1/01/2012 and 31/12/2019 were included in the study. We excluded patients who underwent other types of Bariatric procedures or took AHMs for any other reasons

Hypertension

Defined as usage of AHM(s) at least 18 months before surgery.

Remission from hypertension: defined as no prescribed AHMs for one year after surgery.

Results

475 patients underwent bariatric surgery at WRH between 1/01/2012 and 31/12/2019; 193 patients met the inclusion criteria; LRYGB 52% (n = 101) Vs LSG 48% (n = 92). RR after LRYGB - Year 1: 40% and Year 2: 43%; Vs LSG -Year 1: 40.8% and Year 2: 43.1%. Number of preoperative AHMs, 1 AHM: 53% RR; 2 AHMs: 36% RR and ≥ 3 AHM: 18% RR; (P value = 0.0009). Age ≤45 years: 58% RR Vs >45 years: 37% RR; (P value = 0.024). RR in ≤ 45 years after LRYGB: 77.8% Vs LSG: 39.3% (P value = 0.0085).

Conclusions

There was no significant difference in RR between LRYGB Vs LSG, sex or BMI. Patients ≤ 45 years and those taking fewer AHMs before surgery had a significantly higher RR. Patients ≤45 years who underwent LRYGB had maximum RR from HTN.