NDLI: THE BLOOD PRESSURE REDUCTION AFTER GASTRIC BYPASS SURGERY IS EXPLAINED BY A DECREASE IN CARDIAC OUTPUT.

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THE BLOOD PRESSURE REDUCTION AFTER GASTRIC BYPASS SURGERY IS EXPLAINED BY A DECREASE IN CARDIAC OUTPUT.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Van Brussel, Peter Mathijs Van Den Bogaard, Bas de Weijer, Barbara A. Truijen, Jasper Krediet, Paul Ct Janssen, Ignace M. Van De Laar, Arnold Kaasjager, Karin A. Fliers, Eric Van Lieshout, Johannes J. Serlie, Mireille Johanna Van Den Born, Bert-jan H.
Description	Author Affiliation: van Brussel PM ( Academisch Medisch Centrum p.m.vanbrussel@amc.uva.nl.); van den Bogaard B ( Academic Medical Center.); de Weijer BA ( Academic Medical Center.); Truijen J ( Academic Medical Center.); Krediet PC ( University of Amsterdam.); Janssen IM ( Rijnstate Ziekenhuis Arnhem.); van de Laar A ( Slotervaart Hospital.); Kaasjager KA ( University Medical Center Utrecht.); Fliers E ( Academic Medical Center, University of Amsterdam.); Van Lieshout JJ ( Academic Medical Center.); Serlie MJ ( Academic Medical Center.); van den Born BH ( Academic Medical Center.)
Abstract	BACKGROUND: Blood pressure (BP) decreases in the first weeks after Roux-and-Y gastric bypass surgery. Yet, the pathophysiology of the BP lowering effects observed after gastric bypass surgery are incompletely understood. METHODS: We evaluated BP, systemic hemodynamics and baroreflex sensitivity in 15 obese women (mean age 42±7 yrs, body mass index 45±6 kg/m ) two weeks before and six weeks following Roux-and-Y gastric bypass surgery. RESULTS: Six weeks after gastric bypass surgery mean body weight decreased by 13±5 kg (10%, p<0.001). Office blood pressure (BP) decreased from 137±10/86±6 to 128±12/81±9 mmHg (p<0.001, p<0.01), while daytime ambulatory BP decreased from 128±14/80±9 to 114±10/73±6 mmHg (p=0.01, p=0.05), whereas night-time BP decreased from 111±13/66±7 to 102±9/62±7 mmHg (p=0.04, p<0.01). The decrease in BP was associated with a 1.6±1.2 L/min (20%, p<0.01) decrease in cardiac output (CO), while systemic vascular resistance increased (153±189 dyn.s/cm , 15%, p<0.01). The maximal rise in systolic blood pressure decreased (192 mmHg/s, 19%, p=0.01), suggesting a reduction in left ventricular contractility. Baroreflex sensitivity increased from 9.0 [6.4-14.3] to 13.8 [8.5-19.0] ms·mmHg (median [IQR]; p<0.01) and was inversely correlated with the reductions in heart rate (R= -0.64, p=0.02) and CO (R= -0.61, p=0.03). In contrast, changes in body weight were not correlated with changes in either BP or CO. CONCLUSIONS: The BP reduction following Roux-and-Y gastric bypass surgery is correlated with a decrease in CO independent of changes in body weight. The contribution of heart rate to the reduction in CO together with enhanced baroreflex sensitivity suggests a shift towards increased parasympathetic cardiovascular control.
File Format	HTM / HTML
ISSN	87507587
e-ISSN	15221601
Journal	Journal of Applied Physiology
Language	English
Publisher	American Physiological Society
Publisher Date	2016-10-20
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Applied Physiology Molecular Biology Biochemistry
Content Type	Text
Resource Type	Article
Subject	Physiology Physiology (medical) Sports Science

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