Time Course of Blood Pressure Decrease After Bariatric Surgery in Normotensive and Hypertensive Patients.

BACKGROUND: Bariatric surgery leads to remission of several obesity-related comorbidities, including hypertension. Although antihypertensive medication use is decreased after bariatric surgery, the exact time course of decrease in blood pressure after surgery is not known. METHODS: A database of patients undergoing bariatric surgery at our institute was used to study the effect of surgery on time course of blood pressure changes. Data from surgeries performed between January 2010 and December 2012 were used. RESULTS: Maximum blood pressure and body weight decreases were observed at 2 weeks and 1 year after surgery, respectively. Average decrease in the mean arterial pressure (MAP) was 4.46 mmHg (61.5 ± 17.1% of maximal decrease) and 7.17 mmHg (maximum decrease) at 1 and 2 weeks after surgery, when the decrease in body weight is 22.8 ± 1.6 and 28 ± 1.4% of maximal weight loss, respectively. In hypertensive patients, MAP decreased from 98.5 ± 0.78 to 92.3 ± 1.76 and 93.1 ± 0.92 mmHg at 1 and 2 weeks post-surgery, respectively. In normotensive patients, the MAP decreased from 96.2 ± 0.79 to 88.7 ± 1.25, 90.0 ± 0.94, 86.5 ± 1.35, 88.0 ± 1.13, and 86.4 ± 2.13 mmHg at 2 weeks, 3 and 6 months, and 1 and 3 years after surgery, respectively. CONCLUSIONS: These data demonstrate that significant decrease in MAP occurs within 2 weeks after bariatric surgery in hypertensive as well as normotensive patients. Future studies are required to investigate the weight-independent mechanisms of blood pressure decreases after bariatric surgery.