High blood pressure after weight loss surgery

Comparison of hypertension remission and relapse after sleeve gastrectomy and one-anastomosis gastric bypass

Status

Active, not recruiting

Phases

Unknown

Study type

Observational

Source

ISRCTN

Registry ID

ISRCTN32751856

Enrollment

4320

Registered

2022-06-13

Start date

2013-03-31

Completion date

Unknown

Last updated

2023-06-05

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Hypertension Circulatory System

Interventions

A prospective cohort study with a follow-up of three years was conducted on severely obese patients between 2013 and 2018 in the context of Tehran Obesity Treatment Study who underwent sleeve gastrect

Eligibility

Sex/Gender

All

Inclusion criteria

Inclusion criteria: 1. Enrollment in the TOTS study with a body mass index >35 2. Participants aged 18 years and over 3. Preoperative hypertension 4. Bariatric surgery consisting of sleeve gastrectomy or one-anastomosis gastric bypass

Exclusion criteria

Exclusion criteria: 1. Secondary hypertension (secondary to renal sclerosis, primary hyperaldosteronism, conns syndrome, renovascular problems) 2. Chronic kidney disease with eGFR < 60 3. Current Cancer 4. Revisional bariatric surgery

Design outcomes

Primary

Measure	Time frame
1. Hypertension (HTN) remission, as defined in established guidelines, measured using a mercury sphygmomanometer twice on the left arm for a minimum of 30 seconds while the patient was seated on a chair and using the Korotkoff sound technique at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery. HTN was defined as systolic blood pressure (SBP) equal to or above 140 mm Hg or diastolic blood pressure (DBP) equal to or above 90 mm Hg. In patients with preoperative HTN, remission was identified on the day on which the patient met all of the following three criteria: 1.1. SBP <140 mm Hg 1.2. DBP <90 mm Hg 1.3. Discontinuation of antihypertensive drugs 2. HTN relapse, which due to the lack of a clear definition was defined as the deterioration of HTN remission, measured using a mercury sphygmomanometer twice on the left arm for a minimum of 30 seconds while the patient was seated on a chair and using the Korotkoff sound technique at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery. Relapse in the patients who experienced remission after bariatric surgery was defined as follows: 2.1. The need for prescribing any antihypertensive drug regardless of BP 2.2. SBP = 140 mm Hg or DBP = 90 mm Hg 3. Biochemical parameters in blood samples collected between 7 and 9 am after 12 to 14 hours of overnight fasting were measured on the same day: 3.1. Fasting plasma glucose, as measured using the enzymatic colorimetric method at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery 3.2. Serum triglyceride, as measured using the enzymatic colorimetric method at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery 3.3. Total cholesterol, as measured using the enzymatic colorimetric method at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery	—

Measure

Time frame

1. Hypertension (HTN) remission, as defined in established guidelines, measured using a mercury sphygmomanometer twice on the left arm for a minimum of 30 seconds while the patient was seated on a chair and using the Korotkoff sound technique at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery. HTN was defined as systolic blood pressure (SBP) equal to or above 140 mm Hg or diastolic blood pressure (DBP) equal to or above 90 mm Hg. In patients with preoperative HTN, remission was identified on the day on which the patient met all of the following three criteria: 1.1. SBP <140 mm Hg 1.2. DBP <90 mm Hg 1.3. Discontinuation of antihypertensive drugs 2. HTN relapse, which due to the lack of a clear definition was defined as the deterioration of HTN remission, measured using a mercury sphygmomanometer twice on the left arm for a minimum of 30 seconds while the patient was seated on a chair and using the Korotkoff sound technique at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery. Relapse in the patients who experienced remission after bariatric surgery was defined as follows: 2.1. The need for prescribing any antihypertensive drug regardless of BP 2.2. SBP = 140 mm Hg or DBP = 90 mm Hg 3. Biochemical parameters in blood samples collected between 7 and 9 am after 12 to 14 hours of overnight fasting were measured on the same day: 3.1. Fasting plasma glucose, as measured using the enzymatic colorimetric method at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery 3.2. Serum triglyceride, as measured using the enzymatic colorimetric method at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery 3.3. Total cholesterol, as measured using the enzymatic colorimetric method at pre-surgery, 3-, 6-, 12-, 18-, 24-, and 36-months post-surgery

—

Secondary

Measure	Time frame
The relationship between remission and relapse of HTN was measured using a Cox regression analysis of risk factors such as: 1. Smoking measured using a questionnaire (never, past, current smoker) at baseline 2. Diabetes as defined as fasting plasma glucose = 126 mg/dl or hemoglobin A1C = 6.5 or current medication therapy for a definite diagnosis of diabetes at baseline 3. Lack of appropriate weight loss after surgery measured using EWL < 70% at one tear after surgery (EWL% = [Initial weight - Postop weight] / [Initial weight - Ideal weight] * 100) 4. Old age measured using a questionnaire (more than 45 years) at baseline 5. High consumption of antihypertensive drugs was measured using a questionnaire (more than two antihypertensive drugs) at baseline	—

Measure

Time frame

The relationship between remission and relapse of HTN was measured using a Cox regression analysis of risk factors such as: 1. Smoking measured using a questionnaire (never, past, current smoker) at baseline 2. Diabetes as defined as fasting plasma glucose = 126 mg/dl or hemoglobin A1C = 6.5 or current medication therapy for a definite diagnosis of diabetes at baseline 3. Lack of appropriate weight loss after surgery measured using EWL < 70% at one tear after surgery (EWL% = [Initial weight - Postop weight] / [Initial weight - Ideal weight] * 100) 4. Old age measured using a questionnaire (more than 45 years) at baseline 5. High consumption of antihypertensive drugs was measured using a questionnaire (more than two antihypertensive drugs) at baseline

—

Countries

Iran

Outcome results

None listed

Source: ISRCTN (via WHO ICTRP) · Data processed: Feb 4, 2026