Did you know that close to one in four Australians has high blood pressure? This week is the Heart Foundation’s Heart Week (30 April – 6 May 2017). The topic on the agenda this year, is Hypertension, the medical term for constant high blood pressure. Hypertension is recognised as one of the risk factors for cardiovascular disease and stroke. Studies have also shown a close relationship between hypertension and obesity. We examine how hypertension relates to your heart health. We also see how obesity can make you more at risk of hypertension. Finally, we look at your options for preventing, managing and treating obesity-related hypertension.

The topic of high blood pressure is often on the agenda with patients, for both our general surgery and bariatric practices. It is one of those early warning signs – in any person – that your health needs attention. Because in many people, hypertension can be prevented or treated, having your G.P. take your blood pressure is one of the best health checks you can partake in regularly.

obesity-related hypertension

Causes of and Treatments for High Blood Pressure

In some people, hypertension has a specific medical cause, and once treated they can be cured. But in most other people, age and or lifestyle factors have caused hypertension. Medications can play a significant role in treating hypertension, and often people with a tendency to hypertension will be on medication for life. But medications can only go so far. Lifestyle modification is also an important part of treatment.

For many people, their G.P. will also prescribe a better diet, including a restricted sodium and higher potassium intake. They will insist sufferers give up smoking if they do so. In addition, they will encourage them to get more active with an exercise program and to reduce stress in daily life. These aspects all help to reduce blood pressure in hypertension sufferers. (1)

The problem is, controlling hypertension in an obese patient becomes more difficult.

About Obesity-Related Hypertension

It has been noted that blood pressure increases as body mass index increases. A 2013 study Treatment of Hypertension in Obese Patients found that for every 10% increase in body weight, systolic blood pressure is estimated to increase by 6.5mmHg (2).  So it is evident that increasing body weight increase your risk of developing hypertension.

Firstly, the study also shows, and in our own experience, obese patients can be at a greater risk of being resistant to the medication required or may require more medication at higher doses to control high blood pressure (3).

Secondly, following the general guidelines for managing blood pressure can be difficult for someone who is obese. If you are a person with a body mass index of 40 or more, the advice to ‘get moving and lose a little weight,’ whilst still valid, can be incredibly difficult to achieve. We recognise that for many patients obesity is the disease which must be addressed, well before hypertension.

Surgical Treatment

For those people who are morbidly obese, hypertension can co-exist with other life-threatening obesity-related health issues. These can include type 2 diabetes, heart disease, obstructive sleep apnoea, back and joint problems, depression and even some cancers.

Metabolic surgery can intervene to reverse some obesity-related diseases, and in particular, it has been shown to be particularly effective in reducing obesity-related hypertension.

A review of 33 studies involving 3,997 patients showed that on average, 75% of patients experienced resolution or improvement of their hypertension after laparoscopic sleeve gastrectomy (LSG) surgery.

“Based on our systematic review, LSG has a significant effect on hypertension, inducing resolution or improvement in the majority of cases. Therefore, LSG remains a viable surgical option in obese patients with hypertension,” the 2013 review concluded (4).

We believe addressing excess weight and obesity has nothing to do with appearance, and everything to do with living a long, healthy life. Surgery is a life-saving choice for many patients who cannot lose weight with diet and exercise alone and should be viewed that way.

Don’t Forget to Check!

It must be noted, that although obese people are at a higher risk, high blood pressure can happen to anyone. Most times the symptoms of Hypertension are silent but can be managed if caught early. If left untreated, hypertension can lead to a heart attack; stroke; heart disease and kidney disease. So don’t forget to reach out and have a heart this week, encouraging someone you love to get their blood pressure checked. You could just save their life!

For more information, visit the Heart Foundation’s Heart Week website.

 

Further Reading:

(1) http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442454958
(2) http://www.medscape.com/viewarticle/807018_2
(3) http://www.medscape.com/viewarticle/807018_2
(4) https://www.ncbi.nlm.nih.gov/pubmed/22350987

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