Gastric bypass procedure is one of several weight loss surgery techniques used to treat obesity. During this procedure the stomach is divided into two pouches and the upper one is connected with a loop of small intestine. Thus the actual volume of stomach receiving food and the length of the small intestine participating in the digestion process is reduced. This gastric procedure raised a lot of discussions about whether bariatric surgery could actually be effective in treating co-morbidities of obesity, such as hypertension.
Hypertension is a common condition among middle-aged and elderly people. It is attributed to a list of so-called “Lifestyle diseases”, or “Diseases of civilization” along with other morbidities such as type 2 diabetes mellitus, atherosclerosis, metabolic syndrome, heart disease, cancer, obesity and others. Many of these diseases share the same or very similar pathogenic pathways and therefore are related; very often they go together or are the cause of one another. Hypertension is also known as “the silent killer” as it usually has no symptoms but due to severe late complications hypertension has a substantial effect on the overall quality of life. It also increases mortality rates. Persistent hypertension is an independent predisposing factor for a stroke, heart, kidney and eye diseases.
The impact of obesity and hypertension on public health is increasing worldwide. According to studies, obese people are prone to hypertension and vice versa. Although not all underlying pathophysiologic mechanisms are clarified, it is known that overweight and obesity are related to an activation of sympathetic nervous system, impaired kidney function, artery wall thickening and certain changes in the hormonal system, regulating blood pressure. Altogether these factors contribute to an increase in blood pressure, which then independently affects target organs.
The link between obesity and hypertension is well established. Furthermore, studies also have shown that there is a reverse dependence between body weight and blood pressure: whilst reducing the former, simultaneously better control of the latter is achieved.
Interestingly, the same positive effect on hypertension control was obtained after a multitude of various bariatric surgeries, including gastric bypass. According to one study, almost a half of the gastric bypass procedure patientshad complete resolution of hypertension at 12 months follow-up and in addition to that, another20 percent had significant improvement. Such results are quite remarkable, considering that hypertension is generally a chronic disease, requiring a lifelong treatment.