Blood Pressure Check

Want to Control Hypertension? Treating Obesity Helps

This is not exactly startling news. But two new studies this week do offer a very clear confirmation of one of the important benefits that comes from treating obesity – unmistakably better control of hypertension.

One reason this is important is the substantial amount of disinformation that circulates to suggest obesity is not a real medical problem. These data offer clarity about the evidence telling reasonable people that it is.

Hypertension Five Years After Metabolic Surgery

The first of these two studies comes from the Journal of the American College of Cardiology. Carlos Schiavon and colleagues conducted a randomized clinical trial (RCT) of one hundred patients with obesity and hypertension. Researchers randomly assigned the persons in this study to either gastric bypass surgery plus medical therapy or to medical therapy without surgery. One hundred subjects with an average BMI of 37 enrolled. The study excluded subjects with poorly controlled diabetes or prior cardiovascular events. Females comprised 76% of the study population.

After five years, the subjects in the surgery group were less likely to require medications to control their blood pressure – 47% had their hypertension in remission. In the control group, which received medical therapy alone, only two percent had hypertension in remission. Persons in the control group, on average, had to take three medications to control their blood pressure. At the end of the study, average BMI was 28 in the surgery group and 36 for the controls.

Schiavon et al conclude that metabolic surgery provides lasting relief from hypertension.

Effect of Tirzepatide on Blood Pressure

The second study appears in Hypertension. It is preplanned analysis of 24-hour ambulatory blood pressure in 600 patients from the SURMOUNT-1 RCT of tirzepatide in persons with overweight or obesity (but not diabetes). Patients received either a placebo or one of three different doses of tirzepatide weekly.

After 36 weeks, blood pressure was significantly lower for patients receiving any of the the three tirzepatide doses compared to placebo. James de Lemos and colleagues conclude:

“These data provide further evidence for the potential benefits of tirzepatide on cardiometabolic health and cardiovascular outcomes.”

A New Era

Though the knowledge that untreated obesity leads to hypertension is not new, a clear understanding and the means to bring down hypertension by treating obesity certainly is. Yale cardiologist Harlan Krumholz tells us that this marks an important milestone:

“It’s a new era. This isn’t a new insight, but now we have the tools – these anti-obesity medications and surgery – that can have profound benefits.”

Now all we must do is to drive prices down and increase access to these important therapies for obesity.

Click here for the Schiavon study and here for the de Lemos study. For further perspective, click here.

Blood Pressure Check, public domain photograph by / Wikimedia Commons

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February 8, 2024