Analysis of the effectiveness of laparoscopic sleeve gastrectomy for obese patients with primary hypertension

Objective To investigate the effectiveness of laparoscopic sleeve gastrectomy (LSG) in the treatment of obese patients with primary hypertension. Methods A total of 60 obese patients with hypertension were enrolled, who underwent LSG in the Affiliated Hospital of Xuzhou Medical University from July 2013 to August 2018. Their clinical data and follow-up results one year after surgery were retrospectively analyzed. Their improvement and remission in hypertension were compared before and one year after surgery. Results All the patients successfully completed LSG, including 30 men and 30 women, aging 16 to 60 years, with an average age of (36.9 ±9.7) years old. There were 42 patients with complete remission of hypertension one year after surgery, with a remission rate of 70%. The patients' body weight decreased from (120.3±25.1) kg to (84.5±14.9) kg (P<0.01); body mass index (BMI) decreased from (40.8±6.7) kg/m² to (28.7±3.9) kg/m² (P<0.01); and blood pressure decreased from (154.8±16.7)/(101.0±14.2) mmHg to (125.8±9.3)/(81.4±7.0) mmHg (P<0.01). The remission of hypertension after LSG was related to the duration of hypertension, hypertension grade, systolic and diastolic blood pressures before surgery, and medication taking before surgery (P<0.05), rather than patient age, sex, preoperative BMI, the presence of other metabolic syndromes before surgery and the percentage of excess weight loss (EWL%) in patients one year after surgery (P>0.05). Conclusions Laparoscopic sleeve gastrectomy is safe and effective to treat primary hypertension, with significant weight loss. LSG shows unsatisfied effects on obese patients with long duration of hypertension and high grade of hypertension who require oral antihypertensive agents to control blood pressure before surgery.