MONDAY, Sept. 28, 2020 — Metabolic surgery on patients with morbid obesity and pharmacologically treated hypertension is associated with lower risk for major adverse cardiovascular events (MACE) and all-cause mortality versus individuals with hypertension from the general population, according to a study published online Sept. 15 in PLOS Medicine.
Erik Stenberg, M.D., Ph.D., from Örebro University in Sweden, and colleagues used data from the Scandinavian Obesity Surgery Register, the Swedish National Patient Registers for in-hospital and outpatient care, the Swedish Prescribed Drug Register, and Statistics Sweden in order to identify 11,863 patients with morbid obesity and pharmacologically treated hypertension operated on with metabolic surgery (gastric bypass and sleeve gastrectomy) and 26,199 nonsurgical controls with hypertension matched for age, sex, and area of residence.
The researchers found that MACE occurred in 379 operated-on patients (3.2 percent) and 1,125 subjects in the control group (4.5 percent). A reduction in risk remained in the metabolic surgery group (adjusted hazard ratio [HR], 0.73; 95 percent confidence interval [CI], 0.64 to 0.84; P < 0.001) after adjustment for duration of hypertension, comorbidities, and education. There was also a lower risk for acute coronary syndrome events in the surgery group (adjusted HR, 0.52; 95 percent CI, 0.41 to 0.66; P < 0.001) with a tendency toward lower risk for cerebrovascular events (adjusted HR, 0.81; 95 percent CI 0.63 to 1.01; P = 0.060) versus controls.
“Metabolic surgery should be considered in the treatment of patients with hypertension and morbid obesity,” the authors write.
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