Obesity Surgery | 2021
The Impact of Bariatric Surgery Versus Non-Surgical Treatment on Blood Pressure: Systematic Review and Meta-Analysis
Abstract
The purpose of this study was to compare bariatric surgery versus non-surgical treatment on blood pressure for patients with obesity. Nineteen RCTs (1353 total patients) were included. In the pooled analyses, bariatric surgery reduces more systolic blood pressure (WMD:\u2009−\u20093.937 mmHg, CI95%:\u2009−\u20096.000 to\u2009−\u20091.875, p\u2009<\u20090.001, I2\u2009=\u20090%), diastolic blood pressure (WMD:\u2009−\u20092.690 mmHg, CI95%:\u2009−\u20093.994 to\u2009−\u20091.385, P\u2009<\u20090.001, I2\u2009=\u20090%) and more antihypertensives. In subgroup analyses, patients after Roux-en-Y gastric bypass, with poor control of hypertension (BP\u2009>\u2009130/80 mmHg) and diabetes mellitus (HbA1C\u2009>\u20097.0%, FPG\u2009>\u20097.0 mmol/L), elder patients (>\u200945 years), non-severe obesity (BMI\u2009<\u200940 kg/cm2, body weight\u2009<\u2009120 kg), less waist circumference (<\u2009115 cm) tend to decrease more blood pressure. Besides, patients after surgery also lost more weight (p\u2009<\u20090.001), decreased more waist circumference (p\u2009<\u20090.001), fasting plasma glucose (p\u2009<\u20090.001), glycosylated hemoglobin (p\u2009<\u20090.001), triglycerides (p\u2009<\u20090.001), hsCRP (p\u2009=\u20090.001), increased more high-density lipoprotein cholesterol (p\u2009<\u20090.001), and had better remission of metabolic syndrome (p\u2009<\u20090.001). Changes in total cholesterol, low-density lipoprotein cholesterol, renal function, resting heart rate, and 6-min walking test were not significantly different. Therefore, bariatric surgery is more effective than non-surgical treatment in controlling patients’ blood pressure.