Related Experiment Video
Updated: Jun 24, 2025
06:47
A Murine Model of Vertical Sleeve Gastrectomy
Published on: December 18, 2017
11.1K
Antihypertensive Medication Use Trajectories After Bariatric Surgery: A Matched Cohort Study
Jesse E Passman1, Elizabeth Wall-Wieler2,3, Yuki Liu2
1Department of Surgery (J.E.P.), Perelman School of Medicine, University of Pennsylvania, Philadelphia.
Hypertension (Dallas, Tex. : 1979)
|June 4, 2024
Summary
Metabolic and bariatric surgery (MBS) significantly reduces antihypertensive medication (AHM) use in obese adults. MBS patients showed lower AHM use and higher discontinuation rates, suggesting a preventative role for hypertension.
Area of Science:
- Obesity Medicine
- Cardiovascular Health
- Surgical Interventions
Background:
- Metabolic and bariatric surgery (MBS) is a leading treatment for obesity.
- Hypertension is a common comorbidity in obese individuals.
- Understanding the impact of MBS on antihypertensive medication (AHM) use is crucial.
Purpose of the Study:
- To compare AHM use trajectories in obese individuals who underwent MBS versus those who did not.
- To assess the long-term effects of MBS on hypertension management.
Main Methods:
- A 1:1 matched cohort study using a US employer-based claims database.
- Included adults with a body mass index (BMI) of ≥35 kg/m².
- Analyzed monthly AHM use for 3 years post-index date using generalized estimating equations.
Main Results:
- MBS patients exhibited sustained lower AHM use (17% vs. 32% at 36 months).
- 42% of MBS patients discontinued AHM compared to 7% of medically treated patients (P<0.01).
- MBS was associated with reduced risk of treatment-resistant hypertension and lower AHM initiation in non-hypertensive individuals.
Conclusions:
- MBS is associated with decreased AHM use and increased discontinuation.
- MBS demonstrates effectiveness in both treating and preventing hypertension in obese individuals.
- These findings support MBS as a key intervention for managing obesity-related cardiovascular risk.
Related Concept Videos
01:16Antihypertensive Drugs: Action of Diuretics
665
Diuretics are antihypertensive drugs used to treat hypertension resulting from sodium and water retention. Sodium, vital for fluid balance and nerve or muscle function, is regulated by the kidneys through millions of nephrons. Blood enters nephrons via afferent arterioles, which branch into capillaries called glomeruli. These filter blood plasma, allowing water and solutes, like sodium ions, to pass through capillary walls into Bowman's capsule. The filtrate then flows through various...
665
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
421
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
421
01:30Antihypertensive Drugs: Angiotensin II Receptor Blockers
711
In the renin-angiotensin-aldosterone system, a hormone called angiotensin II plays a crucial role. It binds to the AT1 receptors in vascular smooth muscles coupled with Gq proteins. The activation of these receptors activates an enzyme called phospholipase C, which releases two molecules: inositol trisphosphate and diacylglycerol. These molecules cause a chain reaction that leads to the phosphorylation of myosin light chains and promotes interaction between actin and myosin, leading to smooth...
711
01:28Antihypertensive Drugs: Types of β-Blockers
642
β receptors are classified into three subclasses: β1, β2, and β3. β1 receptors are primarily located in the heart and kidneys. When they get activated, they increase heart rate, contractility, and renin release. This process enhances blood pressure and aids in stress management. In contrast, β2 receptors are situated mainly in the lungs, blood vessels, and skeletal muscles. Upon activation, they trigger smooth muscle relaxation, causing bronchodilation and...
642
01:26Treatment for Pulmonary Arterial Hypertension: Receptor Tyrosine Kinase Inhibitors and Calcium Channel Blockers
157
Receptor tyrosine kinase inhibitors (TKIs) and calcium channel blockers (CCBs) are two critical categories of drugs employed in the treatment of pulmonary artery hypertension (PAH). PAH is a disease that causes high blood pressure in the pulmonary arteries, resulting in chest pain, fatigue, and shortness of breath.
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
TKIs, such as imatinib (Gleevec), are particularly effective in tackling the growth and mitogenic factors that become upregulated in PAH patients. These factors contribute to the...
157
01:31Adrenergic Antagonists: ɑ and β-Receptor Blockers
432
Third-generation β-blockers, such as labetalol and carvedilol, represent a significant advancement in managing cardiovascular conditions. Unlike conventional β-blockers, which can induce peripheral vasoconstriction, third-generation drugs block α1 adrenoceptors. This promotes vasodilation through several mechanisms, such as increased nitric oxide production, inhibition of calcium ion entry, opening of potassium ion channels, and antioxidant action. Labetalol, for instance, is...
432