Effect of bariatric surgery on blood pressure response to exercise in a severely obese population

Exaggerated blood pressure response to exercise is a cardiovascular risk factor associated to higher morbidity and mortality. Severely obese patients have an increased risk of exercise-induced hypertension (EIH). We aimed to assess the blood pressure response to exercise in patients with severe obesity who underwent bariatric surgery as well as the main determinants of this response.

We used data from the ACTIVE clinical trial, in which 60 severely obese patients who underwent bariatric surgery were enrolled. Anthropometric measurements, abdominal and mid-thigh computed tomography scans and maximal exercise testing were performed before bariatric surgery, as well as 3 and 6 months post-surgery. EIH was defined as a maximal SBP ≥210 mmHg for men and ≥190 mmHg for women.

At baseline, 62% of patients had EIH. At 6 months, we observed an EIH resolution rate of 39%. The main determinant of EIH resolution was sex. Actually, patients with EIH resolution were mostly women without resting hypertension and a lower amount of visceral adipose tissue.

These results suggest that bariatric surgery is efficient to resolve EIH, particularly in women with initially a better anthropometric profile.