Intragastric balloon therapy (IGBT) with the Orbera intragastric balloon (Apollo EndoSurgery) produces short-term weight reduction modality with a relatively little risk of adverse event and the subsequent improvement on systolic blood pressure can help reduce cardiovascular risk, according to a study in 140 patients by researchers from East Carolina University, Greenville, NC. The outcomes were published in the paper, ‘Impact of intragastric balloon on blood pressure reduction: A retrospective study in Eastern North Carolina’, in the World Journal of Gastrointestinal Endoscopy.
The aim of the study was to investigate the impact of intragastric balloon on the impact of weight reduction at baseline compared to six-months on blood pressure reduction (he cut-offs for systolic and diastolic blood pressures were 140 and 90 respectively). This allowed for the creation of binary outcome variables-hypertension and non-hypertension for both systolic and diastolic blood pressures, the investigators noted.
The researchers carried out a retrospective chart review from January 2016 to January 2019 in 172 patients had the Orbera intragastric balloon. Of the 172 patients who had IGBT at baseline, 11 patients (6.4%) requested early balloon removal due to foreign body sensation (n=1) and/or intolerable gastrointestinal adverse events (n=10). The reported gastrointestinal adverse events were nausea, vomiting, abdominal pain and diarrhoea. At six-months, data were available for 140 patients.
The study included 15% males and 85% females (50% of the patients were white and just over 22% were non-white, and about 27% declined to give their race) and the average baseline patients’ weight prior to IGBT was 231.61lbs/105kgs (SD=46.53lbs.). Prior to surgery 12.86% patients with had hyperlipidaemia, 30% depression, 2.86% coronary artery disease, 5.71% cardiovascular disease, 17.86% obstructive sleep apnoea and 21.43% Type 2 diabetes mellitus.
The average patients’ weight after IGBT at the six-month follow-up was 203.88lbs/92.5kgs (SD = 41.04 Lbs.). Therefore, the average percent total body weight loss at was 11.97 after IGBT. Logistic regression revealed that weight (p<0.000) and age (p<0.000) are important factors in determining systolic blood pressure after IGBT. None of the other demographic characteristics or indicated comorbidities were found to be significant.
The result reveals a statistically significant reduction in weight at the six-months and the study authors revealed that there was a weak but positive correlation between total body weight and systolic blood pressure ( =0.280), and total body weight and diastolic blood pressure (r=0.132
After controlling for other cofounders like comorbidities and patient demographic characteristics, weight was identified as an important factor for predicting the systolic blood pressure of the study participants (p<0.000). Conversely, it was revealed that weight was not significantly associated with the diastolic blood pressure of the study participants (p<0.138).
The results specifically indicated that for every unit increase in weight, the log odds of systolic blood pressure will increase by 1.4%. Also, for every unit increase in age, the log odds of systolic blood pressure will increase by 5.34%. No variable included in the study however showed a significant association with diastolic blood pressure after IGBT.
The study authors added that the study has several limitations, including the retrospective analysis of a single-centre analysis and the absence of a control group, and the follow-up period was only at the six-month time period of balloon removal, and therefore, weight loss sustainability cannot be concluded.
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