Achieving Blood Pressure Targets and Antihypertensive Effects through Metabolic Surgery in Type 2 Diabetes Patients with Hypertension.

AIMS The effect of metabolic surgery compared with that of conventional therapy on target blood pressure (BP)and defined daily dose (DDD) of antihypertensive drugs in type 2 diabetes mellitus (T2DM) patients with hypertension remains unclear. This study aimed to investigate the differences in target BP and DDD between metabolic surgery and conventional treatment in T2DM patients with hypertension. MATERIALS AND METHODS This was a prospective study of 535 diabetes patients who underwent metabolic surgery (n=112) and medical treatment (n=423). Changes in the target BP from baseline to every follow-up were analysed. RESULTS Metabolic surgery decreased both office systolic and diastolic BP (DBP) and also significantly reduced ambulatory systolic BP(SBP) (132±2 vs 119±1 mmHg, p<0.0001), but not DBP (78 ±1 vs 76±1mmHg, p=0.177).The proportion of patients who maintained their SBP at <120 mmHg after 2 years (50% vs 1.9%, p<0.0001). Moreover, the rate of achieving the target SBP of 130 and 140 mmHg was also significantly higher in the surgery group, and this started from the initial 6months after commencing treatment to the end of follow-up. The dosage (DDD: 1.44±0.65 vs 0.32±0.05, p<0.001) of antihypertensive medication was significantly decreased in after metabolic surgery. Further, metabolic surgery, but not medical treatment, markedly improved the risks of atherosclerotic cardiovascular disease. CONCLUSIONS Metabolic surgery can effectively achieve the BP target and reduce the usage of antihypertensive medications as well as improve multiple metabolic dysfunction in T2DM patients with hypertension. This study provides an alternative approach to antagonize the metabolic related hypertension. This article is protected by copyright. All rights reserved.