Obesity Surgery

, Volume 19, Issue 7, pp 845–849 | Cite as

Laparoscopic Roux-en-Y Gastric Bypass and Its Early Effect on Blood Pressure

  • Ahmed R. AhmedEmail author
  • Gretchen Rickards
  • Deb Coniglio
  • Yinglin Xia
  • Joseph Johnson
  • Thad Boss
  • William O’Malley
Research Article



Laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery is known to have a significant effect on obesity-related comorbidities such as hypertension curing it in some (50–70%) while improving control in others. Our aim was to observe the changes in blood pressure (BP) in a cohort of 100 patients followed prospectively for 1 year after LRYGB.


BP measurements were recorded prospectively in 100 consecutive patients preoperatively and then postoperatively at weeks 1, 5, 9, and months 6 and 12. In order to reduce bias, three BP measurements were made by the same nurse at each office visit and the mean recorded. Pre- and postoperative usage of antihypertensive medication was also noted.


Eighty-nine women and 11 men underwent LRYGB and their BP monitored for 1 year. There was an 85% follow-up rate with mean % excess body weight loss of 60. Reductions in systolic (9 mmHg) and diastolic (7 mmHg) BP measurements were seen as early as week 1 postoperatively and maintained for the duration of the observation period (P < 0.05). Furthermore, postoperative usage of antihypertensive medication is reduced to a third of preoperative use.


LRYGB is associated with an early reduction in BP and antihypertensive medication usage which is maintained at 1 year after surgery. This early impact on blood pressure occurs before any significant weight loss is achieved thereby suggesting a hormonal mechanism that may be involved for the changes observed.


Blood pressure Hypertension Gastric bypass Weight loss 



This publication was made possible by Grant Number 1 UL1 RR024160-01 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at Information on Re-engineering the Clinical Research Enterprise can be obtained from


  1. 1.
    Adams TD, Gress RE, Smith SC et al (2007) Long-term mortality after gastric bypass surgery. N Engl J Med 357:753–61CrossRefGoogle Scholar
  2. 2.
    Sjöström L, Narbro K, Sjöström CD et al (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357:741–52CrossRefGoogle Scholar
  3. 3.
    Must A, Spadano J, Coakley EH et al (1999) The disease burden associated with overweight and obesity. JAMA 282:1523–9CrossRefGoogle Scholar
  4. 4.
    Goldstein DJ (1992) Beneficial health-effects of modest weight loss. Int J Obes 16:397–415Google Scholar
  5. 5.
    Buchwald H, Avidor Y, Braunwald E et al (2004) Bariatric surgery. A systematic review and meta-analysis. JAMA 292 14:1728, OctCrossRefGoogle Scholar
  6. 6.
    Fazylov R, Soto E, Merola S (2008) Laparoscopic Roux-en-Y gastric bypass in morbidly obese patients >/=55 years old. Obes Surg 18:656–9, Apr 12CrossRefGoogle Scholar
  7. 7.
    Fernstrom J, Courcoulas A, Houck P et al (2006) Long-term changes in blood pressure in extremely obese patients who have undergone bariatric surgery. Arch Surg 141:276–283CrossRefGoogle Scholar
  8. 8.
    Carson JL, Ruddy ME, Duff AE et al (1994) The effect of gastric bypass surgery on hypertension in morbidly obese patients [published erratum appears in Arch Intern Med 1994 Aug 8;154 15:1770]. Arch Intern Med 154:193–200CrossRefGoogle Scholar
  9. 9.
    Reinhold RB (1994) Late results of gastric bypass surgery for morbid obesity [see comments]. J Am Coll Nutr 13:326–31CrossRefGoogle Scholar
  10. 10.
    Foley EF, Benotti PN, Borlase BC et al (1992) Impact of gastric restrictive surgery on hypertension in the morbidly obese. Am J Surg 163:294–7CrossRefGoogle Scholar
  11. 11.
    Sugerman HJ, Wolfe LG, Sica DA et al (2003) Diabetes and hypertension in severe obesity and effects of gastric bypass-induced weight loss. Ann Surg 237:751–6PubMedPubMedCentralGoogle Scholar
  12. 12.
    Czupryniak L, Strzelczyk J, Pawlowski M et al (2005) Circadian blood pressure variation in morbidly obese hypertensive patients undergoing gastric bypass surgery. AJH 18:446–51PubMedGoogle Scholar
  13. 13.
    Pories WJ, Swanstrom MS, MacDonald KG et al (1995) Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Am Surg 222:339–50Google Scholar
  14. 14.
    Husain S, Ahmed AR, Johnson J et al (2007) Small-bowel obstruction after laparoscopic Roux-en-Y gastric bypass: etiology, diagnosis, and management. Arch Surg 142 10:988–93CrossRefGoogle Scholar
  15. 15.
    Chobanian AV, Bakris GL, Black HR et al (2003) The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC report. JAMA 289:2560–72CrossRefGoogle Scholar
  16. 16.
    Sjostrom L, Lindroos AK, Peltonen M et al (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351:2683–93CrossRefGoogle Scholar
  17. 17.
    Cunneen SA, Phillips E, Fielding G et al (2008) Studies of Swedish adjustable gastric band and Lap-Band: systematic review and meta-analysis. Surg Obes Relat Dis 4 2:174–85CrossRefGoogle Scholar
  18. 18.
    Aggarwal S, Kini SU, Herron DM (2007) Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis 3 2:189–94CrossRefGoogle Scholar
  19. 19.
    Gagner M, Matteotti R (2005) Laparoscopic biliopancreatic diversion with duodenal switch. Surg Clin North Am 85 1:141–9CrossRefGoogle Scholar
  20. 20.
    Sjostrom CD, Peltonen M, Wedel H et al (2000) Differentiated long-term effects of intentional weight loss on diabetes and hypertension. Hypertension 36:20–5CrossRefGoogle Scholar
  21. 21.
    Clements RH, Gonzalez QH, Long CI et al (2004) Hormonal changes after Roux-en-Y gastric bypass for morbid obesity and the control of type II diabetes mellitus. Am Surg 70:1–4PubMedGoogle Scholar
  22. 22.
    Yamamoto H, Kishi T, Lee C et al (2003) Glucagon-like peptide-1-responsive catecholamine neurons in the area postrema link peripheral glucagon-like peptide-1 with central autonomic control sites. J Neurosci 23 7:2939–46CrossRefGoogle Scholar
  23. 23.
    Gutzwiller JP, Tschopp S, Bock A et al (2004) Glucagon-like peptide 1 induces natriuresis in healthy subjects and in insulin-resistant obese men. J Clin Endocrinol Metab 89 6:3055–61CrossRefGoogle Scholar
  24. 24.
    Ruano M, Silvestre V, Castro R et al (2005) Morbid obesity, hypertensive disease and the rennin–angiotensin–aldosterone axis. Obes Surg 15 5:670–6CrossRefGoogle Scholar
  25. 25.
    Pickering TG (1994) Blood pressure measurement and detection of hypertension. Lancet 344:31–5CrossRefGoogle Scholar
  26. 26.
    Livingston E (2005) Treating obesity-related hypertension with surgery. AJH 18:443–5PubMedGoogle Scholar
  27. 27.
    Sugerman HJ, Kellum JM Jr, DeMaria EJ et al (1996) Conversion of failed or complicated vertical banded gastroplasty to gastric bypass in morbid obesity. Am J Surg 171:263–9CrossRefGoogle Scholar

Copyright information

© Springer Science + Business Media, LLC 2008

Authors and Affiliations

  • Ahmed R. Ahmed
    • 1
    • 3
    Email author
  • Gretchen Rickards
    • 1
  • Deb Coniglio
    • 1
  • Yinglin Xia
    • 2
  • Joseph Johnson
    • 1
  • Thad Boss
    • 1
  • William O’Malley
    • 1
  1. 1.Division of Bariatric and Gastrointestinal SurgeryUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Departmentof Biostatistics and Computational BiologyUniversity of Rochester Medical CenterRochesterUSA
  3. 3.Division of Bariatric and Gastrointestinal SurgeryHighland HospitalRochesterUSA

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