The Effects of Bariatric Surgery on the Requirement for Antihypertensive Treatment in Type 2 Diabetes: Insights from a Long-Term Follow-Up Study.

IF 3.8 3区医学 Q2 Medicine Diabetes Therapy Pub Date : 2024-09-01 Epub Date: 2024-07-27 DOI:10.1007/s13300-024-01627-1

Adrian Heald, Fahmida Mannan, Ryan Wiltshire, Parisa Ghaffari, Unaiza Waheed, Dragan Zdravkovic, Bilal Bashir, Akheel Syed, Rachelle Donn, Handrean Soran

{"title":"The Effects of Bariatric Surgery on the Requirement for Antihypertensive Treatment in Type 2 Diabetes: Insights from a Long-Term Follow-Up Study.","authors":"Adrian Heald, Fahmida Mannan, Ryan Wiltshire, Parisa Ghaffari, Unaiza Waheed, Dragan Zdravkovic, Bilal Bashir, Akheel Syed, Rachelle Donn, Handrean Soran","doi":"10.1007/s13300-024-01627-1","DOIUrl":null,"url":null,"abstract":"Introduction: Bariatric surgery (BS) has emerged an effective intervention in achieving significant and sustained weight loss in patients with type 2 diabetes (T2D). However, comprehensive data on the long-term impact of BS on hypertension is scarce. We aimed to investigate the long-term impact of BS on blood pressure management in individuals within a T2D cohort.Methods: This retrospective cohort study was conducted on 119 patients who underwent BS between 2009 and 2012. Baseline and follow-up observations, including blood pressure, HbA1c, BMI, and antihypertensive medication use were obtained from electronic patient records at regular intervals up to and beyond 10-year follow-up.Results: The median follow-up period for the 119 patients was 11.5 years. Mean fall in BMI 4-8 weeks post-surgery was 12%. A sustained reduction in systolic BP was observed up to 10 years post-surgery (154.5 mmHg pre-op vs. 132.8 mmHg at 10 years; p < 0.0001. From 5 years onwards, there were increases in mean glycated hemoglobin (HbA1c) and body mass index (BMI). At latest follow-up (> 5 years after bariatric surgery), the number of individuals prescribed an antihypertensive agent started to increase. This is in the context of the number of the number of individuals on 2-3 antihypertensive agents declining up until 5 years post-BS. Specifically, there was a reduction in the number of prescriptions of an antihypertensive agent over time from 164 prescriptions pre-operatively to 81 at 8 weeks post-operatively, 78 at 6 months, 72 at 1 year, 66 at 5 years before rising at 10 years to 95 prescriptions.Conclusions: Our study shows an overall benefit in the years after bariatric surgery in terms of blood pressure and requirement for antihypertensive medication. However, at 5 years and beyond after surgery, the beneficial effect of bariatric surgery diminishes with respect to an increase in number of antihypertensive medication prescriptions, BMI, and HbA1c.","PeriodicalId":11192,"journal":{"name":"Diabetes Therapy","volume":null,"pages":null},"PeriodicalIF":3.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11330420/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diabetes Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s13300-024-01627-1","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/27 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Bariatric surgery (BS) has emerged an effective intervention in achieving significant and sustained weight loss in patients with type 2 diabetes (T2D). However, comprehensive data on the long-term impact of BS on hypertension is scarce. We aimed to investigate the long-term impact of BS on blood pressure management in individuals within a T2D cohort.

Methods: This retrospective cohort study was conducted on 119 patients who underwent BS between 2009 and 2012. Baseline and follow-up observations, including blood pressure, HbA1c, BMI, and antihypertensive medication use were obtained from electronic patient records at regular intervals up to and beyond 10-year follow-up.

Results: The median follow-up period for the 119 patients was 11.5 years. Mean fall in BMI 4-8 weeks post-surgery was 12%. A sustained reduction in systolic BP was observed up to 10 years post-surgery (154.5 mmHg pre-op vs. 132.8 mmHg at 10 years; p < 0.0001. From 5 years onwards, there were increases in mean glycated hemoglobin (HbA1c) and body mass index (BMI). At latest follow-up (> 5 years after bariatric surgery), the number of individuals prescribed an antihypertensive agent started to increase. This is in the context of the number of the number of individuals on 2-3 antihypertensive agents declining up until 5 years post-BS. Specifically, there was a reduction in the number of prescriptions of an antihypertensive agent over time from 164 prescriptions pre-operatively to 81 at 8 weeks post-operatively, 78 at 6 months, 72 at 1 year, 66 at 5 years before rising at 10 years to 95 prescriptions.

Conclusions: Our study shows an overall benefit in the years after bariatric surgery in terms of blood pressure and requirement for antihypertensive medication. However, at 5 years and beyond after surgery, the beneficial effect of bariatric surgery diminishes with respect to an increase in number of antihypertensive medication prescriptions, BMI, and HbA1c.

Abstract Image

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

减肥手术对 2 型糖尿病患者抗高血压治疗需求的影响：长期随访研究的启示。

导言：减肥手术（Bariatric surgery，BS）已成为一种有效的干预措施，可使 2 型糖尿病（T2D）患者的体重得到显著而持续的减轻。然而，有关减肥手术对高血压长期影响的全面数据却很少。我们旨在研究 BS 对 T2D 队列中的个体血压管理的长期影响：这项回顾性队列研究针对 2009 年至 2012 年期间接受 BS 的 119 名患者。从电子病历中定期获取基线和随访观察结果，包括血压、HbA1c、BMI 和降压药使用情况，直至随访 10 年及 10 年以上：119 名患者的随访时间中位数为 11.5 年。术后4-8周体重指数平均下降12%。手术后 10 年，收缩压持续下降（术前 154.5 mmHg，10 年后 132.8 mmHg；减肥手术后 5 年 p），服用降压药的人数开始增加。而在肥胖手术后 5 年内，服用 2-3 种降压药物的人数一直在减少。具体来说，随着时间的推移，抗高血压药物的处方数量从术前的 164 张减少到术后 8 周的 81 张、6 个月的 78 张、1 年的 72 张、5 年的 66 张，然后在 10 年时增加到 95 张：我们的研究表明，在减肥手术后的几年里，患者的血压和降压药需求量总体上是有益的。然而，在手术后 5 年及以后，减肥手术的益处随着降压药物处方数量、体重指数和 HbA1c 的增加而减弱。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Diabetes Therapy Medicine-Endocrinology, Diabetes and Metabolism

CiteScore

6.90

自引率

7.90%

发文量

130

审稿时长

6 weeks

期刊介绍： Diabetes Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all areas of diabetes. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Diabetes Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research.