Hormonal
Metabolic surgery (specifically RYGB and SG) is an effective treatment for obesity-related hypertension, achieving hypertension remission in approximately 50-56% of patients and reducing medication burden significantly compared to medical therapy alone.
If you have obesity and high blood pressure that isn't controlled by lifestyle changes or medications, metabolic surgery (like gastric bypass or sleeve gastrectomy) is a highly effective option. It can lead to the remission of hypertension in more than half of patients, often reducing or eliminating the need for blood pressure medications. While lifestyle changes are the first step, they often fail long-term; surgery offers a durable solution for severe cases.
In the GATEWAY trial... remission of hypertension (defined as a BP <140/90 mmHg without medication use) was attained in significantly more patients in the surgery group (56% vs. 0%).
Why this rating
Supported by Level I evidence (GATEWAY RCT) and extensive meta-analyses of observational studies, though long-term durability (>5 years) data is noted as limited.
Source
Obesity-related hypertension: a review of pathophysiology, management, and the role of metabolic surgery
Omair A. Shariq et al. · Gland Surgery · 2020
DOI 10.21037/gs.2019.12.03
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