Metabolic Surgery for Hypertension in Patients with Obesity

Abstract

The global prevalence of overweight and obesity has risen substantially over the past 4 decades and is accompanied by an increasing burden of cardiovascular risk factors such as hypertension. Metabolic surgery is the most effective method to treat obesity and may further improve associated conditions. Although most research has been directed toward the glycemic effects of weight loss surgery, there has been a growing interest in exploring its potential blood pressure-reducing properties. Systematic reviews and meta-analyses based primarily on observational data have suggested that metabolic surgery may aid in controlling hypertension. Only one randomized controlled trial specifically addressing this concept has been conducted, though supportive of the findings from observational studies. We review contemporary procedures for weight loss and their effects on cardiometabolic risk, particularly hypertension. In addition, we describe potential pathophysiological mechanisms and the effects of metabolic surgery on cardiovascular events and mortality.