Weight loss surgery offers hope for patients with obesity-induced hypertension

•    One person in the UAE suffers from a stroke every hour, with 70% of the stroke patients diagnosed with hypertension; 40.8% of UAE nationals in the age-group of 35-70 suffer from hypertension
•    Obese patients who had bariatric surgery experience significant and long-term blood pressure improvements as they lose weight from the procedure, even help eliminate need for high blood medication
•    The American Surgecenter explains benefits of weight loss surgery in light of World Hypertension Day on May 17

Abu Dhabi, United Arab Emirates; April 16, 2015: As obesity rates continue to rise in the UAE, the risk of developing chronic health complications is also becoming more prevalent in the country. Hypertension, an obesity-related disease tagged as a silent killer in the UAE, is blamed for the alarming stroke cases registered in the country last year – one person suffers from a stroke every hour, with 70 per cent of the stroke patients diagnosed with hypertension – this according to a stroke specialist in the country. A 2013 study by the Dubai Health Authority confirmed that hypertension is rampant among Emiratis, with 40.8 per cent of UAE nationals in the age-group of 35-70 suffering from hypertension. Globally, one in three adults has hypertension and 90.4 million deaths occur annually due to hypertension worldwide, based on the same research.

In observance of World Hypertension Day on May 17, The American Surgecenter, a state of the art medical facility providing sophisticated quality healthcare in Abu Dhabi, is helping to raise wider awareness on the complications of high blood pressure and how the disease can be managed.

Dr. Patrick Noel, Laparoscopic and Bariatric Surgeon for The American Surgecenter, said, “Living a healthy lifestyle is one of your best defence against hypertension. Unfortunately there are people who, despite earnest and repeated efforts to follow a balanced diet and engage in regular exercise, do not respond to these lifestyle modifications; they are still unable to manage their high-blood pressure and therefore, remain at risk.  At this point, bariatric surgery can be considered as the best and healthiest treatment option for weight loss and managing hypertension.”

Bariatric surgery is a safe and effective operation that is performed to help obese individuals lose weight.  The National Institutes of Health in the USA, one of the world's foremost medical research centres, recognises bariatric surgery as an effective treatment to combat severe obesity and maintain weight loss in the long term, thus helping improve or resolve many obesity-related conditions, among them hypertension.  

Dr. Noel emphasised that weight loss surgery is not a quick fix option and one must meet the prescribed criteria to be a candidate for the procedure.  To be eligible for the procedure, you must at least meet these primary criteria: your body mass index (BMI) should be 40 or higher; you weigh at least 60 pounds more than your ideal weight; and, your age is above 18 years (although it can be done for a younger age in extreme cases). “A hypertensive patient could qualify if BMI is at 35 and above. Surgery could be done safely with controlled hypertension. Before surgery, your blood pressure should be treated and controlled,” the doctor explains.

Gastric sleeve and gastric bypass surgery are the most common weight loss operations, accounting for about 80 per cent of all weight loss surgeries worldwide. The surgeon decides which surgery is best for the patient based on several factors, such as age, medical history, diet history, and previous surgeries. Several studies revealed that obese patients who have undergone bariatric surgery experience significant and long-term blood pressure improvements as they lose weight from the procedure.  Relative to this, a significant percentage of patients who were under active medication for hypertension before the surgery were able to eliminate or reduce their drug treatment after the surgery.

One of the most recent findings was published last year in Surgery for Obesity and Related Diseases, the official journal of the American Society for Metabolic and Bariatric Surgery (ASMBS), in which Dr. Philip Schauer, Member of the ASMBS, wrote that during long term follow-up (after 6 years), the benefits of gastric by-pass in diabetic patients showed an improvement or a resolution of glycated hemoglobin in 85 per cent of patients, and an improvement in blood pressure in 63 per cent of patients.  In another systematic review, Dr. Nancy Puzziferri, Assistant Professor of Surgery and part of the bariatric surgery team at the University of Texas Southwestern Medical Center, wrote in The Journal of the American Medical Association 2014 that based on clinical studies on 7,371 cases, gastric by-pass gave better results over gastric banding for long term weight loss, for type 2 diabetes control and remission and for hypertension (maximum 140/90 mm Hg without treatment in 60.4 per cent of by-pass patients compared to 22.7 per cent for banding).  Additionally, a 2012 research published in the Obesity Surgery, the official journal of the International Federation for the Surgery of Obesity and Metabolic Disorders showed that from a total of 33 studies involving 3,997 patients, sleeve gastric surgery resulted in a resolution of hypertension in 58 per cent of patients, and improvement or a resolution in 75 per cent.  

While bariatric surgery promises improved health with substantial weight loss as well as lower risks from cardiovascular diseases, Dr. Noel cautions that people who have had bariatric surgery need to adhere to a rigorous and lifelong diet and exercise plan for maximum benefits from the operation. “You will lose weight with bariatric surgery.  However, how well you keep the weight off after the surgery and how healthy you become depends on your determination to follow strict dietary recommendations and engage in regular physical activity,” Dr. Noel concluded.