Abstract 14460: Bariatric Surgery is Associated With Reduced Risk of Hypertension-Related Emergency Department Visits and Unplanned Hospitalizations

Introduction: Hypertension (HTN) carries a large societal burden. Obesity is known as a risk factor for HTN, and uncontrolled HTN can lead to end-organ damage (e.g., hypertensive heart disease with or without heart failure, hypertensive kidney disease, and hypertensive encephalopathy). However, little is known as to whether weight loss interventions, such as bariatric surgery, reduce the risk of HTN-related end-organ damage. Hypothesis: Bariatric surgery is associated with a reduced risk of emergency department (ED) visits and unplanned hospitalizations for HTN-related end-organ damage in obese adults. Methods: We performed a self-controlled case series study (each individual serves as his/her own control) of obese patients with HTN who underwent bariatric surgery, using the population-based ED and inpatient sample in 3 states (California, Florida, and Nebraska) from 2005 to 2011. Primary outcome was ED visit or unplanned hospitalization for HTN-related end-organ damage. We used conditional logistic regression to compare the risk of outcome event during sequential 12-month periods, using pre-surgery months 13-24 as the reference period. Results: We identified 980 obese patients with HTN who underwent bariatric surgery. During the reference period, 17.8% (95%CI 15.4%-20.2%) of patients had the primary outcome event. The risk remained unchanged in the subsequent 12-month pre-surgery period (18.2% [15.7%-20.6%]; adjusted odds ratio (aOR) 1.02 [0.83-1.27]; P=0.83). In the first 12-month period after bariatric surgery, the risk was significantly lower (10.5% [8.6%-12.4%]; aOR 0.58 [0.45-0.74]; P Conclusion: Bariatric surgery is associated with a reduced risk of HTN-related end-organ damage requiring ED evaluation or unplanned hospitalization in obese patients with HTN.