Resolution of hypertension with weight loss

Hypertension is a major risk factor for Cardiovascular Disease, the most common cause of death in Western Societies. Obese individuals are more prone to hypertension and weight loss has been shown to lead to significant reductions in blood pressure. The underlying mechanisms for this benefit are poorly understood. Leptin is a hormone that is produced by fat and contributes to a sensation of satiety. When an individual loses weight, leptin levels typically fall and this is thought to contribute to that individual feeling hungry and regaining weight. We have preliminary data suggesting a role for leptin in Hypertension resolution with weight loss. In this study we seek to serially assess obese patients with hypertension who have undergone laparoscopic adjustable gastric band surgery (LAGB) for weight loss. LAGB is a weight loss surgery that works by inducing satiety without changing the hormonal milleu, and as such is a reliable model of conservative weight loss. We have recently demonstrated that maximal blood pressure improvement occurs with an TBWL of 20% following LAGB surgery, which is usually achieved at 12 months. We will measure change in blood pressure, weight change and leptin levels monthly for 12 months. Other putative drivers of blood pressure change will also be measured.