Gastric Bypass Surgery Is Followed by Lowered Blood Pressure and Increased Diuresis - Long Term Results from the Swedish Obese Subjects (SOS) Study
To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain. Cohort study with data from the...
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| Published in | PloS one Vol. 7; no. 11; p. e49696 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
29.11.2012
Public Library of Science (PLoS) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1932-6203 1932-6203 |
| DOI | 10.1371/journal.pone.0049696 |
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| Abstract | To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake.
In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain.
Cohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively).
At long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: -5.1 mm Hg) and diastolic pressure (-5.6 mmHg) differing significantly from both VBG/B (-1.5 and -2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and -3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01).
The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. |
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| AbstractList | To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain. Cohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively). At long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: -5.1 mm Hg) and diastolic pressure (-5.6 mmHg) differing significantly from both VBG/B (-1.5 and -2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and -3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01). The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake.OBJECTIVETo compare two bariatric surgical principles with regard to effects on blood pressure and salt intake.In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain.BACKGROUNDIn most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain.Cohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively).METHODSCohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively).At long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: -5.1 mm Hg) and diastolic pressure (-5.6 mmHg) differing significantly from both VBG/B (-1.5 and -2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and -3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01).RESULTSAt long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: -5.1 mm Hg) and diastolic pressure (-5.6 mmHg) differing significantly from both VBG/B (-1.5 and -2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and -3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01).The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery.CONCLUSIONSThe purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain. Cohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively). At long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: -5.1 mm Hg) and diastolic pressure (-5.6 mmHg) differing significantly from both VBG/B (-1.5 and -2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and -3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01). The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. ObjectiveTo compare two bariatric surgical principles with regard to effects on blood pressure and salt intake.BackgroundIn most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain.MethodsCohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively).ResultsAt long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: -5.1 mm Hg) and diastolic pressure (-5.6 mmHg) differing significantly from both VBG/B (-1.5 and -2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and -3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01).ConclusionsThe purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. Background In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain. Methods Cohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively). Results At long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: −5.1 mm Hg) and diastolic pressure (−5.6 mmHg) differing significantly from both VBG/B (−1.5 and −2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and −3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01). Conclusions The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. Background In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain. Methods Cohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively). Results At long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: -5.1 mm Hg) and diastolic pressure (-5.6 mmHg) differing significantly from both VBG/B (-1.5 and -2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and -3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01). Conclusions The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. Background In most patients bariatric surgery induces a sustained weight loss and a reduced cardiovascular risk profile but the long-term effect on blood pressure is uncertain. Methods Cohort study with data from the prospective, controlled Swedish Obese Subjects (SOS) study involving 480 primary health care centres and 25 surgical departments in Sweden. Obese patients treated with non-surgical methods (Controls, n = 1636 and n = 1132 at 2 y and 10 y follow up, respectively) were compared to patients treated with gastric bypass (GBP, n = 245 and n = 277, respectively) or purely restrictive procedures (vertical banded gastroplasty or gastric banding; VBG/B, n = 1534 and n = 1064, respectively). Results At long-term follow-up (median 10 y) GBP was associated with lowered systolic (mean: −5.1 mm Hg) and diastolic pressure (−5.6 mmHg) differing significantly from both VBG/B (−1.5 and −2.1 mmHg, respectively; p<0.001) and Controls (+1.2 and −3.8 mmHg, respectively; p<0.01). Diurnal urinary output was +100 ml (P<0.05) and +170 ml (P<0.001) higher in GBP subjects than in weight-loss matched VBG/B subjects at the 2 y and 10 y follow-ups, respectively. Urinary output was linearly associated with blood pressure only after GBP and these patients consumed approximately 1 g salt per day more at the follow-ups than did VBG/B (P<0.01). Conclusions The purely restrictive techniques VBG/B exerted a transient blood pressure lowering effect, whereas gastric bypass was associated with a sustained blood pressure reduction and an increased diuresis. The daily salt consumption was higher after gastric bypass than after restrictive bariatric surgery. |
| Audience | Academic |
| Author | Jacobson, Peter Carlsson, Lena M. Hallersund, Peter Fändriks, Lars Näslund, Ingmar Olbers, Torsten Wallenius, Ville Sjöström, Lars Lönroth, Hans |
| AuthorAffiliation | 1 Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden 2 Department of Molecular and Clinical Medicine and Center for Cardiovascular and Metabolic Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Bambino Hospital, Italy |
| AuthorAffiliation_xml | – name: Bambino Hospital, Italy – name: 1 Department of Gastrosurgical Research and Education, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden – name: 2 Department of Molecular and Clinical Medicine and Center for Cardiovascular and Metabolic Research, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden |
| Author_xml | – sequence: 1 givenname: Peter surname: Hallersund fullname: Hallersund, Peter – sequence: 2 givenname: Lars surname: Sjöström fullname: Sjöström, Lars – sequence: 3 givenname: Torsten surname: Olbers fullname: Olbers, Torsten – sequence: 4 givenname: Hans surname: Lönroth fullname: Lönroth, Hans – sequence: 5 givenname: Peter surname: Jacobson fullname: Jacobson, Peter – sequence: 6 givenname: Ville surname: Wallenius fullname: Wallenius, Ville – sequence: 7 givenname: Ingmar surname: Näslund fullname: Näslund, Ingmar – sequence: 8 givenname: Lena M. surname: Carlsson fullname: Carlsson, Lena M. – sequence: 9 givenname: Lars surname: Fändriks fullname: Fändriks, Lars |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/23209592$$D View this record in MEDLINE/PubMed https://gup.ub.gu.se/publication/169140$$DView record from Swedish Publication Index |
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| ContentType | Journal Article |
| Copyright | COPYRIGHT 2012 Public Library of Science 2012 Hallersund et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2012 Hallersund et al 2012 Hallersund et al |
| Copyright_xml | – notice: COPYRIGHT 2012 Public Library of Science – notice: 2012 Hallersund et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: https://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. – notice: 2012 Hallersund et al 2012 Hallersund et al |
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| DOI | 10.1371/journal.pone.0049696 |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Competing Interests: The authors would like to declare the following: Dr. Lars Sjöström, reports serving as a member of the board of Lenimen, receiving lecture fees from AstraZeneca and Johnson & Johnson, and providing an expert statement on drug effects and weight-loss effects on obesity for AstraZeneca; Dr Hans Lönroth reports receiving unrestricted research grants and travel grants from Johnson & Johnson; Dr. Lena Carlsson reports receiving consulting fees from AstraZeneca and owning stock in Sahltech; Dr Lars Fändriks reports receiving unrestricted reaserch grants from VSL#3 Pharmaceutical Inc. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials. Conceived and designed the experiments: PH LF LS LMC. Performed the experiments: LS IN TO PJ HL VW. Analyzed the data: PH LF LMC LS VW. Wrote the paper: PH LF. Intellectual content: LMC LS IN TO PJ HL VW. Statistical analysis: PH. Obtained funding: LF LMC HL LS. Administrative, technical, or material support: IN TO PJ HL VW. Study supervision: LF LMC LS. |
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| Snippet | To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake.
In most patients bariatric surgery induces a sustained... Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. Background In most patients bariatric surgery... To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. In most patients bariatric surgery induces a sustained... To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake.OBJECTIVETo compare two bariatric surgical principles... To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. ObjectiveTo compare two bariatric surgical principles with regard to effects on blood pressure and salt intake.BackgroundIn most patients bariatric surgery... Objective To compare two bariatric surgical principles with regard to effects on blood pressure and salt intake. Background In most patients bariatric surgery... |
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| SubjectTerms | Adult Arterial Pressure Banding Blood Blood Pressure Body Mass Index Body weight loss Cardiovascular disease Cardiovascular diseases Case-Control Studies Clinical medicine Control methods Diabetes Diastolic pressure Diuresis Diurnal Education Ethics Female Follow-Up Studies Food Gastric Bypass Gastroenterologi och hepatologi Gastroenterology and Hepatology Gastrointestinal surgery Health care Health risks Heart surgery Humans Hypertension Kirurgi Laparoscopy Male Medicine Mercury Metabolism Middle Aged Obesity Obesity - surgery Patients Pressure effects Pressure reduction Principles Risk assessment Salt Salts Sodium - urine Stomach Stroke Studies Surgery Weight control Weight loss maintenance Weight reduction |
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| Title | Gastric Bypass Surgery Is Followed by Lowered Blood Pressure and Increased Diuresis - Long Term Results from the Swedish Obese Subjects (SOS) Study |
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