Weight loss surgery reduces hypertension

[Miss Vickie]

In the interests of fair play...

http://news.yahoo.com/s/nm/20060320/hl_nm/obesity_dc;_ylt=Atqp9sXYGrvLtzlhUsdvsEPVJRIF;_ylu= X3oDMTA5aHJvMDdwBHNlYwN5bmNhdA--

What I thought was interesting is that it doesn't take much weight loss -- most of the people in the study are still consered obese -- to make a significant difference in diastolic blood pressure. For those not aware, the diastolic (or "lower number") represents the amount of resistance the heart has to work against to get blood to the extremeties. This number can increase due to extra weight (because of the extra blood vessels laid down to support and nourish fat) and is "probably", they say, more of a problem than a higher systolic ("top number") because the systolic is more affected by environmental stressors.

So even though the study participants are still considered medically obese, they have reduced, significantly, their risk for heart disease. I see that as good news, and it confirms what I suspected, which is that we don't have to get down to what would be for us ridiculously low weights in order to have a health benefit from WLS.

[Sandie S-R]

It has long been held that losing as little as 10% of ones body weight will lower blood pressure, cholestrol, blood sugar, etc. I just think that going thru WLS to lose that 10% seems a bit drastic. I think the idea of finding a diet and exercise program to lose that 10% seems much more manageable and realistic for most of us.

[RedHead]

Vickie...good point. I know many women who are not the "Hollywood" body type; but are still considered overweight; see me for example.

I've never been healthier; but I am not the ideal "poster" girl either for WLS...because I don't weigh 125 lbs.

[Miss Vickie]

It has long been held that losing as little as 10% of ones body weight will lower blood pressure, cholestrol, blood sugar, etc. I just think that going thru WLS to lose that 10% seems a bit drastic. I think the idea of finding a diet and exercise program to lose that 10% seems much more manageable and realistic for most of us.

True, but prior to WLS I couldn't even lose THAT much. (How pathetic is that?) And I didn't have WLS to lose only 10%. Much of us go through WLS to learn upwards of 50% of our excess weight; my surgeon told me that I wouldn't experience an improvement in my joint pain until nearly that 50%, but amazingly, my joint pain, and particularly my foot pain which really surprised him, got better within the first 20 pounds or so.

But yes, you're right, even as "little" as 10%, which for many people is manageable, helps tremendously. It's pretty encouraging because as a fat person, feeling the need to fit into those life insurance charts is pretty damn daunting.

[Miss Vickie]

Vickie...good point. I know many women who are not the "Hollywood" body type; but are still considered overweight; see me for example.

I've never been healthier; but I am not the ideal "poster" girl either for WLS...because I don't weigh 125 lbs.

I'm still considered obese. I figured it out and I have to get down to below 165 to be "just" overweight. I don't see myself getting there, and you know, that's okay.

Besides, labels -- even medical ones -- are for canned peas. ;)

[FitChick]

I lost over 100 lbs., my BP went up. Slightly, but still, it did go up.
I always had low BP when I was very big...in the 110/70 range. It was 150/90 when I was a skinny teenager.

I think in my case its more stress related than weight related. I tended to be more relaxed when I was very big, and the stress seems to go up the smaller I get. I think my body just liked being fat. (shrug)

[Miss Vickie]

I lost over 100 lbs., my BP went up. Slightly, but still, it did go up.
I always had low BP when I was very big...in the 110/70 range. It was 150/90 when I was a skinny teenager.

I think in my case its more stress related than weight related. I tended to be more relaxed when I was very big, and the stress seems to go up the smaller I get. I think my body just liked being fat. (shrug)

All things being equal, our blood pressures rises as we age, due to a loss of elasticity in our arteries. So even if your weight remained stable, odds are that your pressures would creep up over time. This seems to particularly happen to women as we hit our 30's and our hormonal levels change dramatically.

And yeah, absolutely, stress is an enormous factor in blood pressures. I've had patients go from a 108/68 pressure to 144/96 from a phone call with a stressed relative. It's just amazing how that happens.

[NancyGirl74]

I'm so glad you mentioned weight and BP, Vicki! It is the very reason I've lost 50 + pounds and continue to try. My BP is now "under control" due to medication and my weight lose. Frankly, I think it's more my weight loss then anything. I've been on several different kinds of meds but it wasn't until I lost weight that my BP evened out. I continue to try to lose weight (even though it is getting harder and harder) because I don't want to be on the meds at all. I want to lose weight without WLS but I did consider it and sometimes still think about it. However, I truly don't think WLS is the answer for me. As long as I continue to try to lose weight at a slow pace and not gain I think my BP will stay steady and that is what matters the most to me. It's nice being 50 lbs lighter (I can finally shop at Lane Bryant!) but it's even nicer to feel healthy.

Thanks for bringing up an important topic. High BP should not be taken lightly.

[FitChick]

All things being equal, our blood pressures rises as we age, due to a loss of elasticity in our arteries. So even if your weight remained stable, odds are that your pressures would creep up over time. This seems to particularly happen to women as we hit our 30's and our hormonal levels change dramatically.

And yeah, absolutely, stress is an enormous factor in blood pressures. I've had patients go from a 108/68 pressure to 144/96 from a phone call with a stressed relative. It's just amazing how that happens.

Mine was sky high as a (skinny) teenager, mostly due to stress (had a jerk boyfriend...the only bad one I ever had but he sure made up for not having more rotten ones!) He was the trigger for my (then) high BP AND my IBS.

I noticed when I was pregnant that my BP was low...I don't know why that was.

When I was really heavy my BP was around 110/70....now that I'm thinner it averages around 125/80-130/80.

[Miss Vickie]

I noticed when I was pregnant that my BP was low...I don't know why that was.

There is a hormone that is created and released during pregnancy called relaxin. That's why most women's blood pressures go down in pregnancy. I don't know, but I suspect it's the body's way of compensating for the significant increase in blood volume which would otherwise cause an increase in pressures. Also, relaxin helps ... um... "relax" the ligaments in the pelvis and hips, allowing for smoother deliveries. For some of us, higher levels of relaxin are secreted even early in pregnancy and we're particularly sensitive to it; my pubic bone separated with my last two pregnancies at the end of my first trimester which made walking rather problematic. OTOH I have quick second stages and my babies basically fly out so I figure it's overall a good thing.

When I was really heavy my BP was around 110/70....now that I'm thinner it averages around 125/80-130/80.

Yeah, but you're also older now. ;) So weight is AN issue but not the ONLY issue. Aging plays a large role, as well as genetics, diet, other conditions in the body, etc.

[Miss Vickie]

Thanks for bringing up an important topic. High BP should not be taken lightly.

Nancy, I love your avatars. They're so lovely. Do you create the artwork yourself?

I'm glad to hear you're getting your pressures under control; and yes, even a modest weight loss can make a difference, which is pretty exciting news. We may never fit into the "insurance table" fit definition, but at least we can do something to decrease our risk of cardiovascular disease.

You know, you hit the nail on the head with talking about how important it is to treat hypertension. I think it's undertreated because for most people -- unless it's VERY high -- they don't notice it. The problem is that damage is constantly being done to the arteries without you even being aware. And it's not just the larger arteries like the carotid (which feeds the brain) but the smaller ones in the kidneys and eyes which are also damaged. And having 20 years of poorly controlled blood pressure can really mess things up for us as we get older.

And good for you that you're able to lose weight without surgical intervention. I'm very pleased with the progress you've made. I know it's slow going but the changes I assume you're making have their own health benefits.

Keep up the good work!

[RedHead]

Well I have to say that when I was fat I was put on High Blood Pressure Medication; but as soon as I lost my first 25 lbs my BP stabilized and I (other than when I've been in pain) haven't had any more issues at all.

As a matter of fact; my bp is text book awesome (as my doctor likes to say)

Vickie...thanks for the info on the aging part; I was unaware that this could contribute later in life to High BP...do you know of any studies or info that shows the increase due to age...and the various treatments etc??

[Miss Vickie]

Vickie...thanks for the info on the aging part; I was unaware that this could contribute later in life to High BP...do you know of any studies or info that shows the increase due to age...and the various treatments etc??

Hmm. I don't know about studies per se, just that as we age our arteries become less elastic which contributes to hypertension. I think they're starting to think that estrogen as a protective mechanism against that process, which is why they encourage women to take estrogen after menopause. OTOH, the HRT studies seemed to show an increase in cardiovascular disease, which surprised everyone, so obviously it's more complicated than originally thought.

[Wayne_Zitkus]

And of course, some patients have their blood pressure drop to zero after WLS.

We can't forget them......

[Miss Vickie]

And of course, some patients have their blood pressure drop to zero after WLS.

We can't forget them......

Well that was a useful contribution to the topic.

As per usual.

Thanks so much for your input, Wayne. As usual, you've taken my well considered, well informed, well educated arguments -- not to mention the rigorous research being done -- and completely negated them with your usual style and flair.

Well done. ;)

[moonvine]

You know, you hit the nail on the head with talking about how important it is to treat hypertension. I think it's undertreated because for most people -- unless it's VERY high -- they don't notice it. The problem is that damage is constantly being done to the arteries without you even being aware. And it's not just the larger arteries like the carotid (which feeds the brain) but the smaller ones in the kidneys and eyes which are also damaged. And having 20 years of poorly controlled blood pressure can really mess things up for us as we get older.



Vickie, this is kind of off topic for this board, but I have a question. Does low blood pressure do anything bad to you? Is there a point where it gets too low? Could my low blood pressure be contributing to me being cold all the time?

My doctors always say not to worry about it, but I kind of do anyway.

[Dibaby35]

I also had high BP before WLS and now it's under control. Thank God no more pills. I haven't lost a huge amount either and at 253 still considered obese.

[Miss Vickie]

Vickie, this is kind of off topic for this board, but I have a question. Does low blood pressure do anything bad to you? Is there a point where it gets too low? Could my low blood pressure be contributing to me being cold all the time?

My doctors always say not to worry about it, but I kind of do anyway.

You know, they say the same to me, and that's what I learned in school. But still, I wonder... One of the things they measure when they measure is MAP -- mean arterial pressure. And our organs need the MAP to be between certain parameters. (Sorry, I can't remember what they are, but basically to determine MAP there's an algebraic equation involving the systolic and diastolic numbers). Anyway, if the MAP is within parameters, your organs are getting enough blood, but the vessels aren't under too much pressure. It's the pressure on the arteries if you're hypertensive that's the problem, particularly the microvessels in the eyes and kidneys, which is why people with hypertension have kidney and eye problems. It's also bad on the genitals, which is why men have erectile dysfunciton; those little biddy vessels that you want to fill with blood are damaged and it's hello, Viagra.

So, if your MAP is high enough, you're getting enough blood flow to your organs. However, I'm not sure about feeling cold all the time being a symptom of low blood pressure. Are your extremities (hands and feet) cold? Have you had your thyroid checked? In general, at work when I have a patient who has low pressures, the docs and midwives say as long as they're not symptomatic (dizzy, particularly when standing) and as long as their heart rate isn't super high (which could be a sign of a bleed), that it's okay. One thing you're more prone to, though, is postural hypotension. I went from significant, not terribly well controlled hypertension to slightly low pressures and I've noticed now that when I run up the stairs after being in bed all night, I get kind of woozy. Once I took my blood pressure and it was 90/60. Darn, no wonder I was dizzy! :) So do be careful if you get up quickly, because if you're running low, you're more likely to need a little time for those baroreceptors to compensate and pump up the volume, so to speak.

Other than that, I'm just not sure, even though I do wonder and to a degree share your concern. I know there are downsides to cholesterol levels which are too low, sugars which are too low, etc. I realize that hypertension is a HUGE problem, but are there problems from long term sub acute hypotension? I don't know. Sorry about that. :(

[moonvine]

Hi Vickie,

I guess I will try not to worry about it then. I was just curious about being cold all the time because my mom is cold all the time too, and has low blood pressure. But maybe they are genetic things that aren't linked? I haven't had my thyroid checked, no docs have ever mentioned it to me. It isn't just my extremities that are cold, but all of me. When it gets really hot here though I'm not cold!

[NancyGirl74]

Vicki, you should start charging for all this medical advice lol. But since you're not I have another question for you.

What can I do beside losing weight to help lower my BP? I've lost 60 lbs and I seem to be stuck there. I'm having a hard time losing more. I also don't add salt to anything and I try to be aware of the salty foods I do eat. I don't exercise like I should so I know that would be one thing I could do. Is there anything else I could be conscience of? I really would love to get off these meds if possible. Any advice would be helpful. Thanks :D

BTW my Avitars are just tags that people have made for me over the years.

[Sandie_Zitkus]

Thanks so much for your input, Wayne. As usual, you've taken my well considered, well informed, well educated arguments -- not to mention the rigorous research being done -- and completely negated them with your usual style and flair.

Well done. ;)

I don't think he's done that at all Vickie. He's just a smartass at times. It's one of the reasons I love him.

But I think all your posts are worthwhile and intelligent and well thought out.:)

[Miss Vickie]

Vicki, you should start charging for all this medical advice lol. But since you're not I have another question for you.

What can I do beside losing weight to help lower my BP? I've lost 60 lbs and I seem to be stuck there. I'm having a hard time losing more. I also don't add salt to anything and I try to be aware of the salty foods I do eat. I don't exercise like I should so I know that would be one thing I could do. Is there anything else I could be conscience of? I really would love to get off these meds if possible. Any advice would be helpful. Thanks :D




Oooh, careful there. I can't be giving true "advice", just talking about trends and sharing knowledge. I don't want to get into trouble, ya know. ;) I'm happy to share what I know, though, particularly with people who want to learn more about the magic of how their body works.

Okay here's what I know about lowering blood pressure.

Weight loss helps, exercise helps (particularly cardio work, which you should never EVER do without being cleared for exercise by your doc, particularly if you have high blood pressure), and there are some herbs and minerals that help that you can get from a naturopathic doctor (garlic and magnesium come to mind).

Sometimes, a tendency toward hypertension is genetic and there's nothing you can do but manage it with lifestyle changes and medication. In my husband's case, he's got a big time family history of hypertension, so he's already prone to it. He can't change that, but he can increase his overall health, cardio and otherwise, by eating well and exercising.

Stress management is also important. Some people react to stress with a spike in pressures, so finding ways to cope with stress, if that's a trigger for you, is important. Salt is a culprit in about 25% of people. Since we can't predict which 25% are salt sensitive, the general recommendation is to cut back on salt, particularly since most Americans eat too much salt anyway.

So those are some ideas. And while weight is important, it's not the only factor since there are lots of thin folks out there with hypertension.


BTW my Avitars are just tags that people have made for me over the years.

You have nice friends. They're lovely. :)

[Miss Vickie]

But I think all your posts are worthwhile and intelligent and well thought out.:)

Thank you. :)