Bariatric surgery reverses blunted blood pressure reactivity to cold-induced stress in patients with severe obesity

IF 2.4 4区医学 Q3 ENDOCRINOLOGY & METABOLISM

Obesity research & clinical practice Pub Date : 2026-03-01 Epub Date: 2026-04-10 DOI:10.1016/j.orcp.2026.03.005

Leticia Schwambach , Maria Fernanda Dantas Aguilar , Paulo Henrique Luiz Junior , João Arthur Souza Fiorido , Maria Clara da cruz Pires , Beatriz Bobbio de Brito , Nina Bruna de Souza Mawandji , Gustavo Peixoto Soares Miguel , Dalton Valentim Vassallo , Blanca Elena Guerrero Daboin , Fabiano Kenji Haraguchi , Andressa Bolsoni-Lopes

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引用次数: 0

Abstract

Background

Autonomic dysfunction is a pathway linking obesity to cardiovascular disease, contributing to hypertension and impaired pressor control. Individuals with obesity often show blunted blood pressure (BP) reactivity to stressors, such as the cold pressor test (CPT), consistent with maladaptive autonomic adjustments. Roux-en-Y gastric bypass (RYGB) produces substantial weight loss and metabolic improvements, and lowers resting BP, yet its effects on stress reactivity are underexplored. Therefore, this study evaluated the impact RYGB on BP reactivity to cold-induced stress and its associations with body composition, metabolic, inflammatory, and oxidative stress markers.

Methods

A prospective longitudinal study was conducted with 30 adults with obesity (BMI 35–55 kg/m²) in a public hospital. Participants underwent clinical, anthropometric, biochemical, and cardiovascular evaluations preoperatively and at two- and six-months post-surgery. The CPT assessed BP, heart rate (HR), and rate–pressure product (RPP) responses.

Results

Bariatric surgery significantly reduced body weight, fat mass, waist circumference, glucose, insulin, HOMA-IR, cholesterol, triglycerides, C-reactive protein, and advanced oxidation protein products (p < 0.05). Resting systolic and diastolic BP, HR, and RPP also decreased, indicating improved baseline cardiovascular status. Pressor reactivity to CPT, blunted preoperatively, was restored postoperatively, with significant systolic and diastolic BP increases during cold exposure. Correlations showed that greater pressor reactivity was associated with lower adiposity, insulin resistance, cholesterol, and oxidative stress.

Conclusion

RYGB restores pressor reactivity to the CPT within six months, alongside reduced adiposity, improved insulin sensitivity, and lower oxidative stress, underscoring its role in reversing obesity-related autonomic dysfunction and mitigating cardiovascular risk.

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减肥手术可逆转严重肥胖患者对冷应激的钝化血压反应。

背景：自主神经功能障碍是将肥胖与心血管疾病联系起来的途径，有助于高血压和血压控制受损。肥胖个体通常表现出对压力源（如冷压试验（CPT））的迟钝的血压（BP）反应，与不适应的自主调节相一致。Roux-en-Y胃旁路术（RYGB）能显著减轻体重，改善代谢，降低静息血压，但其对应激反应的影响尚不清楚。因此，本研究评估了RYGB对BP对冷应激反应的影响及其与身体成分、代谢、炎症和氧化应激标志物的关系。方法：对某公立医院30例肥胖成人（BMI 35-55 kg/m²）进行前瞻性纵向研究。参与者在术前和术后2个月和6个月分别接受了临床、人体测量、生化和心血管评估。CPT评估血压、心率（HR）和心率压积（RPP）反应。结果：减肥手术显著降低了体重、脂肪量、腰围、葡萄糖、胰岛素、HOMA-IR、胆固醇、甘油三酯、c反应蛋白和高级氧化蛋白产物（p ）结论：RYGB在6个月内恢复了CPT的加压反应性，同时减少了肥胖，改善了胰岛素敏感性，降低了氧化应激，强调了其在逆转肥胖相关的自主神经功能障碍和减轻心血管风险中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Obesity research & clinical practice 医学-内分泌学与代谢

CiteScore

7.10

自引率

0.00%

发文量

审稿时长

49 days

期刊介绍： The aim of Obesity Research & Clinical Practice (ORCP) is to publish high quality clinical and basic research relating to the epidemiology, mechanism, complications and treatment of obesity and the complication of obesity. Studies relating to the Asia Oceania region are particularly welcome, given the increasing burden of obesity in Asia Pacific, compounded by specific regional population-based and genetic issues, and the devastating personal and economic consequences. The journal aims to expose health care practitioners, clinical researchers, basic scientists, epidemiologists, and public health officials in the region to all areas of obesity research and practice. In addition to original research the ORCP publishes reviews, patient reports, short communications, and letters to the editor (including comments on published papers). The proceedings and abstracts of the Annual Meeting of the Asia Oceania Association for the Study of Obesity is published as a supplement each year.