Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease
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This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery.Wilcoxon signed-ranks test was used for the statistical analyses. Seventy GERD patients were included in the analysis and followed up for a mean period of 3.5 ± 1.4 years. Prior to surgery, all participating patients were taking at least one class of antihypertensive medication, and 56 patients (80%) had intermittently high blood pressure. After surgery, the mean number of antihypertensive medication classes per patient was significantly reduced from 1.61 ± 0.77 pre-procedure to 1.27 ± 0.88 post-procedure (P < 0.001). The blood pressure of 48 of the 56 cases (86%) with preoperative intermittent high blood pressure returned to normal post procedure. A total of 50 patients (71%) recorded improvements on the hypertension control scale, with the overall mean score decreasing from 3.1 ± 1.0 preprocedure to 1.4 ± 1.0 post-procedure (P < 0.001). Therefore, successful laparoscopic fundoplication may result in better blood pressure control in some hypertensive GERD patients. This result suggests a possible connection between gastroesophageal reflux and hypertension.
Keywordsgastroesophageal reflux disease hypertension blood pressure laparoscopic fundoplication
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This study is supported by Beijing Municipal Science and Technology Commission (No. Z141107002514109).
- 7.Peters JH. Surgical treatment of gastroesophageal reflux disease. Gastroenterol Hepatol (N Y) 2014; 10(4): 247–248Google Scholar
- 13.Liang WT, Yan C, Wang ZG, Wu JM, Hu ZW, Zhan XL, Wang F, Ma SS, Chen MP. Early and midterm outcome after laparoscopic fundoplication and a minimally invasive endoscopic procedure in patients with gastroesophageal reflux disease: a prospective observational study. J Laparoendosc Adv Surg Tech A 2015; 25(8): 657–661CrossRefPubMedGoogle Scholar
- 25.Cuomo R, De Giorgi F, Adinolfi L, Sarnelli G, Loffredo F, Efficie E, Verde C, Savarese MF, Usai P, Budillon G. Oesophageal acid exposure and altered neurocardiac function in patients with GERD and idiopathic cardiac dysrhythmias. Aliment Pharmacol Ther 2006; 24(2): 361–370CrossRefPubMedGoogle Scholar
- 31.Rosztóczy A, Vass A, Izbéki F, Nemes A, Rudas L, Csanády M, Lonovics J, Forster T, Wittmann T. The evaluation of gastrooesophageal reflux and oesophagocardiac reflex in patients with angina-like chest pain following cardiologic investigations. Int J Cardiol 2007; 118(1): 62–68CrossRefPubMedGoogle Scholar
- 32.Swiatkowski M, Budzynski J, Klopocka M, Grad K, Pulkowski G, Augustynska B, Suppan K, Fabisiak J. The effect of eight weeks of rabeprazole therapy on nitric oxide plasma level and esophageal pH and motility and motility nitric oxide plasma level in patients with erosive esophagitis. Med Sci Monit 2004; 10(2): CR46–CR51PubMedGoogle Scholar