Long-Term Effect of Biliopancreatic Diversion on Blood Pressure in Hypertensive Obese Patients

Background The weight loss surgically induced by gastroplasty or gastric banding has only a transitory effect on the arterial hypertension of the severely obese patients, and a prevalence of hypertension similar to that of controls has been reported 8 years after the operation. Methods We studied the effects of biliopancreatic diversion in a series of 73 severely obese patients with preoperative hypertension throughout a 10-year follow-up period. Body weight dropped from 135.5 kg to 84.8 kg and remained substantially unchanged during the entire 10-year period, hypertension resolved in 41 subjects within the first postoperative year and the resolution rate increased slightly and progressively with time: at 10 years only 15 subjects were still hypertensive. Mean systolic and diastolic blood pressure (BP) value decreased within the first postoperative year as well as the pulse pressure (mean ± standard deviation from 168 ± 25 to 143 ± 22 mm Hg, from 105 ± 18 to 88 ± 13 mm Hg, and from 65 ± 16 to 50 ± 13 mm Hg, respectively) and remained essentially unchanged throughout all the follow-up; 10 years after surgery the systolic BP and pulse pressure values (127 ± 14 mm Hg and 42 ± 6 mm Hg, respectively) were significantly lower than those observed at shorter term. Conclusions In severely obese patients with arterial hypertension, the weight loss determined by biliopancreatic diversion in most cases is accompanied by the normalization of BP, which remains into physiological range until very long term.