Effect of Bariatric Surgery on Hypertension

Wilhelm, Sheila M.; Young, Jamie; Kale-Pradhan, Pramodini

doi:10.1177/1060028014529260

Cited by 102 publications

(49 citation statements)

References 65 publications

(147 reference statements)

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“…3 Dyslipidemia is common feature in obese patient and major risk factor for development of atherosclerosis and then heart related diseases. 4 Bariatric surgery has proven to be an effective treatment against obesity related comorbidities achieving high rate of remission in disease such as type 2 DM 5,6 or arterial hypertension 7,8 among others. In these cases of dyslipidemia studies have shown acceptable short term outcome after bariatric surgery reaching more than 85% of resolution in one year.…”

Section: Introductionmentioning

confidence: 99%

Effect of laparoscopic sleeve gastrectomy on lipid profile of obese patients in complete nine month follow up

et al. 2016

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Section: Introductionmentioning

confidence: 99%

Effect of laparoscopic sleeve gastrectomy on lipid profile of obese patients in complete nine month follow up

et al. 2016

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“…While these procedures restructure the gut in various ways, all of them result in comorbid disease remission including T2DM[1203639108118154162166168171173189193202212213214221224231249265273] and MetS,[7303245121132174177183199225243250260270274275] even if at a variable rate and durability;[12314878828397108114168208221224243244267275] though remission has been reported in a number of publications to be durable[139168178191] and immediate prior to significant weight loss. [2074161187188190195]…”

Section: Bariatric Surgery Impact On Hepatic O2mentioning

confidence: 99%

Metabolic syndrome and the hepatorenal reflex

Wider¹

2016

Surg Neurol Int

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Insufficient hepatic O2 in animal and human studies has been shown to elicit a hepatorenal reflex in response to increased hepatic adenosine, resulting in the stimulation of renal as well as muscle sympathetic nerve activity and activating the renin angiotensin system. Low hepatic ATP, hyperuricemia, and hepatic lipid accumulation reported in metabolic syndrome (MetS) patients may reflect insufficient hepatic O2 delivery, potentially accounting for the sympathetic overdrive associated with MetS. This theoretical concept is supported by experimental results in animals fed a high fructose diet to induce MetS. Hepatic fructose metabolism rapidly consumes ATP resulting in increased adenosine production and hyperuricemia as well as elevated renin release and sympathetic activity. This review makes the case for the hepatorenal reflex causing sympathetic overdrive and metabolic syndrome in response to exaggerated splanchnic oxygen consumption from excessive eating. This is strongly reinforced by the fact that MetS is cured in a matter of days in a significant percentage of patients by diet, bariatric surgery, or endoluminal sleeve, all of which would decrease splanchnic oxygen demand by limiting nutrient contact with the mucosa and reducing the nutrient load due to loss of appetite or dietary restriction.

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“…The role of obesity on hypertension development was also confirmed in the studies that showed significant reduction in BP after weight reduction . There are different methods of weight reduction: lifestyle changes, pharmacological intervention, and bariatric surgery . Lifestyle changes such as diet and exercise usually cannot result with clinically significant weight loss .…”

Section: Introductionmentioning

confidence: 88%

“…Pharmacological intervention has not provided satisfactory results so far. Bariatric surgery is an invasive method, but it provides more constant BMI reduction with greater probability of long‐term BP decrease . Even though data regarding long‐term outcomes are lacking, bariatric surgery seems to provide an important renal, cardiovascular, and mortality benefit in obese patients than other types of weight loss …”

Section: Introductionmentioning

confidence: 99%