Remission of hypertension after laparoscopic sleeve gastrectomy versus Roux-en-Y-gastric bypass: a systematic review of randomized control trials

Zevallos A.; Sanches E.E.; Parmar C.; Ribeiro R.; Pouwels S. · Surgery for Obesity and Related Diseases (2025) · DOI: 10.1016/j.soard.2024.10.010

Resumen

Background: Besides its benefits for weight loss, current findings suggest that bariatric surgery can induce remission of hypertension. Limited data report the effect of bariatric surgery on this obesity-associated comorbidity. Objective: Compare the short-term, mid-term, and long-term remission of hypertension after sleeve gastrectomy versus Roux-en-Y gastric bypass. Setting: Meta-analysis of randomized controlled trials (RCTs). Methods: Four databases (Embase, PubMed, Scopus, and Science Direct) were searched for RCTs that compared the effects of sleeve gastrectomy (SG) versus Roux-en-Y gastric bypass (RYGB) on hypertension remission at <1 year, 2–4 years, and ≥5 years. Patients with a history of hypertension and who had primary bariatric surgery were included. Results: After reviewing 11,814 studies, only 11 RCTs were included. In total, the analysis included 2323 patients, with 1158 in the SG group (49.85%) and 1165 in the RYGB group (50.15%). It was found that SG and RYGB procedures had comparable hypertension remission at ≤1 year (Relative risk: 1.11, 95% CI .83–1.48, P = .49), and between 2 and 4 years (Relative risk: 1.11, 95% CI .90–1.37, P = .34). However, there was a significant difference in hypertension remission at ≥ 5 years, favoring RYGB (relative risk: 1.39, 95% CI 1.06–1.82, P = .02). Conclusion: This systematic review and meta-analysis of RCTs demonstrates that RYGB is superior to SG in resolving hypertension beyond 5 years postoperatively. These findings highlight the long-term benefits of RYGB over SG in managing hypertension, providing valuable insights for surgical decision-making and patient counseling.

Instituciones: Universidad Científica del Sur