Background

Bariatric surgery results in rapid weight loss and resolution of comorbidities such as hypertension. We aimed to compare which of the two most common procedures; vertical sleeve gastrectomy (VSG) or Roux-en Y gastric bypass (RYGB) was associated with sustained remission from hypertension and identify other independent predictors of sustained remission.

Methods

This was a retrospective study design using Truven MarketScan database enrollment, inpatient and pharmacy claims from 2010 to 2016. A cohort of hypertensive bariatric patients was created using detailed inclusion and exclusion criteria. Remission was defined as no refill of antihypertensive medication 30 days after a patients’ medication was expected to run out and relapse as medication refill after at least 90 days of remission.

Results

Of 7006 patients in our cohort, 5874 experienced remission of their hypertension (83.8%). 745 of the 5874 (12.7%) patients later experienced relapse. The adjusted relative rate of remission between VSG and RYGB was 1.06 [95% CI; 1.0, 1.11.] The adjusted relative rate of relapse between VSG and RYGB was 0.84 [95% CI; 0.71, 0.97]. A higher number of medications at the time of surgery was associated with a decreasing rate of remission and an increasing rate of relapse of hypertension.

Conclusions

There was no difference in the rate of remission of hypertension between VSG and RYGB. VSG was associated with a decreased rate of relapse of hypertension compared to RYGB.The number of medications at the time of surgery was the most important predictor of remission and relapse of hypertension after surgery.