This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS
Multicentre cohort study of antihypertensive and lipid‐lowering therapy cessation after bariatric surgery. BJS 2019; 106: 286-295.
Published: 16th October 2018
Authors: J. Thereaux, T. Lesuffleur, S. Czernichow, A. Basdevant, S. Msika, D. Nocca et al.
Background
Few studies have assessed changes in antihypertensive and lipid‐lowering therapy after bariatric surgery. The aim of this study was to assess the 6‐year rates of continuation, discontinuation or initiation of antihypertensive and lipid‐lowering therapy after bariatric surgery compared with those in a matched control group of obese patients.
Method
This nationwide observational population‐based cohort study used data extracted from the French national health insurance database. All patients undergoing gastric bypass or sleeve gastrectomy in France in 2009 were matched with control patients. Mixed‐effect logistic regression models were used to analyse factors that influenced discontinuation or initiation of treatment over a 6‐year interval.
Results
In 2009, 8199 patients underwent primary gastric bypass (55·2 per cent) or sleeve gastrectomy (44·8 per cent). After 6 years, the proportion of patients receiving antihypertensive and lipid‐lowering therapy had decreased more in the bariatric group than in the control group (antihypertensives: –40·7 versus –11·7 per cent respectively; lipid‐lowering therapy: –53·6 versus –20·2 per cent; both P < 0·001). Gastric bypass was the main predictive factor for discontinuation of therapy for hypertension (odds ratio (OR) 9·07, 95 per cent c.i. 7·72 to 10·65) and hyperlipidaemia (OR 11·91, 9·65 to 14·71). The proportion of patients not receiving treatment at baseline who were subsequently started on medication was lower after bariatric surgery than in controls for hypertension (5·6 versus 15·8 per cent respectively; P < 0·001) and hyperlipidaemia (2·2 versus 9·1 per cent; P < 0·001). Gastric bypass was the main protective factor for antihypertensives (OR 0·22, 0·18 to 0·26) and lipid‐lowering medication (OR 0·12, 0·09 to 0·15).
Conclusion
Bariatric surgery is associated with a good discontinuation of antihypertensive and lipid‐lowering therapy, with gastric bypass being more effective than sleeve gastrectomy.
Full textYou may also be interested in
Leading article
Authors: C. Chamberlain, J. M. Blazeby
Original article
Authors: S. J. Chapman, R. C. Grossman, M. E. B. FitzPatrick, R. R. W. Brady
Systematic review
Authors: H. K. James, A. W. Chapman, G. T. R. Pattison, D. R. Griffin, J. D. Fisher
Randomized clinical trial
Authors: K. Misawa, Y. Mochizuki, M. Sakai, H. Teramoto, D. Morimoto, H. Nakayama et al.
Systematic review
Authors: J. H. H. Olsen, S. Öberg, K. Andresen, T. W. Klausen, J. Rosenberg
Original article
Authors: L. Heylen, J. Pirenne, U. Samuel, I. Tieken, M. Coemans, M. Naesens et al.
Original article
Authors: L. Cairncross, H. A. Snow, D. C. Strauss, M. J. F. Smith, O. Sjokvist, C. Messiou et al.
Original article
Authors: R. J. Dinsdale, J. Hazeldine, K. Al Tarrah, P. Hampson, A. Devi, C. Ermogenous et al.
Original article
Authors: C. A. Sewalt, E. Venema, E. J. A. Wiegers, F. E. Lecky, S. C. E. Schuit, D. den Hartog et al.
Randomized clinical trial
Authors: R. J. Hopkins, T. Irvine, G. G. Jamieson, P. G. Devitt, D. I. Watson
Article
Authors: A. M Lacy, R. Bravo, A. M. Otero‐Piñeiro, R. Pena, F. B. De Lacy, R. Menchaca et al.
Original article
Authors: P. Ghorbani, T. Troëng, O. Brattström, K. G. Ringdal, T. Eken, A. Ekbom et al.