Bariatric Surgery: Impacting High Blood Pressure Through More Than Weight Loss

According to the Centers for Disease Control, about one in three U.S. adults has high blood pressure (hypertension). Risks include family history, advancing age, poor diet, consuming excessive amounts of alcohol, and being overweight or obese.

Lifestyle changes are a big part of controlling high blood pressure. The main tenets include:

  • Following a healthy diet, which may include reducing salt. The DASH (Dietary Approaches to Stop Hypertension) diet is often recommended. In addition to lowering salt intake, DASH is replete with fruits, vegetables, and low-fat or nonfat dairy. The diet emphasizes whole grains and is rich in potassium, magnesium, calcium and fiber.
  • Exercising regularly.
  • Maintaining a healthy weight.
  • Keeping stress levels at bay. (Stress can cause us to engage in unhealthy blood pressure-raising behaviors.)
  • Drinking only moderate amounts of alcohol.
  • Taking your medications as prescribed.

There are many types of prescription medications that can help control blood pressure and reduce the risk of heart attack or stroke. These medications may need to be taken for life to maintain their effect.

New research is showing, however, that bariatric surgery can allow obese people taking a lot of antihypertensive medications to cut way back on them. Study subjects’ blood pressure was maintained in the normal range with only one agent or even without drugs.

Within a year, those in a recent trial who had bariatric surgery were more than six times as likely to have cut back on their number of blood pressure (BP) medications by hypertension-867855__340about a third. Half of the surgical patients didn’t need any antihypertensive meds to maintain their BP at healthy levels. On the other hand, all of the “standard-care” patients in the study needed antihypertensive medications to keep BP that low, and half of them needed at least three different ones.

Interestingly, most patients in the gastric-bypass group achieved the primary end point in the first month of the postop period. That seems to indicate that something more is happening beyond just weight loss.

That something is likely to be related, at least in part, to the metabolic changes in the surgery group compared with the control group, which included significant improvements in fasting plasma glucose, HbA1c, LDL cholesterol, triglycerides, and high-sensitivity C-reactive protein in addition to the lowering of blood pressure.

If you live in the Las Vegas area and are wondering if bariatric surgery might be right for you, schedule an appointment at VIP Surg. Dr. Tsuda and his team can help find the right treatment for your unique situation.

 

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DASH Your High Blood Pressure Away

DASH stands for Dietary Approaches to Stop Hypertension. The DASH diet is a lifelong approach to healthy eating that’s designed to help treat or prevent high blood pressure (hypertension). The DASH diet encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients that help lower blood pressure, such as potassium, calcium, and magnesium.

Because the DASH diet is a healthy way of eating, it offers health benefits besides just asparagus-2169305_960_720lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke, and diabetes.

The DASH diet emphasizes vegetables, fruits, and low-fat dairy foods — and moderate amounts of whole grains, fish, poultry, and nuts.

Here’s a look at the recommended servings from each food group for the 2,000-calorie-a-day DASH diet:

  • Grains: 6 to 8 servings a day — Grains include bread, cereal, rice and pasta. Examples of one serving of grains include 1 slice whole-wheat bread, 1-ounce dry cereal, or 1/2 cup cooked cereal, rice or pasta.
  • Vegetables: 4 to 5 servings a day — Vegetables are full of fiber, vitamins, and such minerals as potassium and magnesium. Examples of one serving include 1 cup raw leafy green vegetables or 1/2 cup cut-up raw or cooked vegetables.
  • Fruits: 4 to 5 servings a day — Like vegetables, fruits are packed with fiber, potassium and magnesium and are typically low in fat.
  • Dairy: 2 to 3 servings a day — Milk, yogurt, cheese and other dairy products are major sources of calcium, vitamin D and protein. But the key is to make sure that you choose dairy products that are low fat or fat-free because otherwise they can be a major source of fat — and most of it is saturated. Examples of one serving include 1 cup skim or 1 percent milk, 1 cup low fat yogurt, or 1 1/2 ounces part-skim cheese.
  • Lean meat, poultry and fish: 6 servings or fewer a day — Meat can be a rich source of protein, B vitamins, iron and zinc. Choose lean varieties and aim for no more than 6 ounces a day.
  • Nuts, seeds and legumes: 4 to 5 servings a week — Almonds, sunflower seeds, kidney beans, peas, lentils and other foods in this family are good sources of magnesium, potassium and protein. They’re also full of fiber and phytochemicals, which are plant compounds that may protect against some cancers and cardiovascular disease. Serving sizes are small and are intended to be consumed only a few times a week because these foods are high in calories. Examples of one serving include 1/3 cup nuts, 2 tablespoons seeds, or 1/2 cup cooked beans or peas.
  • Fats and oils: 2 to 3 servings a day — Fat helps your body absorb essential vitamins and helps your body’s immune system. But too much fat increases your risk of heart disease, diabetes and obesity. Examples of one serving include 1 teaspoon soft margarine, 1 tablespoon mayonnaise or 2 tablespoons salad dressing.
  • Sweets: 5 servings or fewer a week — You don’t have to banish sweets entirely while following the DASH diet — just go easy on them. Examples of one serving include 1 tablespoon sugar, jelly or jam, 1/2 cup sorbet, or 1 cup lemonade.

While the DASH diet is not a weight-loss program, you may indeed lose unwanted pounds because it can help guide you toward healthier food choices.

Remember, healthy eating isn’t an all-or-nothing proposition. What’s most important is that, on average, you eat healthier foods with plenty of variety — both to keep your diet nutritious and to avoid boredom or extremes. With the DASH diet, you can have both.

If you live in the Las Vegas area and are dealing with health issues that come with obesity, contact VIP Surg. Dr. Tsuda and his team can help you find the treatment that works best for you. Call 702-487-6000 today for an appointment.

 

Metabolic Syndrome: The New Silent Killer

For decades, American waistlines have been expanding, and there is increasing cause for alarm. Experts are saying metabolic syndrome is the new “silent killer,” like hypertension in the 1970s. As it turns out, the “love handle” can be fatal.

What is Metabolic Syndrome?

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke. The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Metabolic syndrome is a cluster of metabolic disorders. When a patient presents with these conditions together, the chances for future cardiovascular disease is greater than any one factor presenting alone.

What are Metabolic Risk Factors?

Risk factors are traits, conditions, or habits that increase one’s chance of developing a disease. The five conditions described below are metabolic risk factors. You can have any one of these risk factors by itself, but they tend to occur together. You must have at least three metabolic risk factors to be diagnosed with metabolic syndrome.

  • A large waistline. This also is called abdominal obesity or “having an apple shape.” Screen Shot 2017-10-24 at 11.41.55 AMExcess fat in the stomach area is a greater risk factor for heart disease than excess fat in other parts of the body, such as on the hips.
  • A high triglyceride level (or you’re on medicine to treat high triglycerides).
  • A low HDL cholesterol level (or you’re on medicine to treat low HDL cholesterol).
  • High blood pressure (or you’re on medicine to treat high blood pressure).
  • High fasting blood sugar (or you’re on medicine to treat high blood sugar).

Your risk for heart disease, diabetes, and stroke increases with the number of metabolic risk factors you have. The risk of having metabolic syndrome is closely linked to overweight and obesity and a lack of physical activity.

Insulin resistance also may increase your risk for metabolic syndrome. Genetics (ethnicity and family history) and older age are other factors that may play a role in causing metabolic syndrome.

Can Metabolic Syndrome be Treated?

Metabolic syndrome is becoming more common due to a rise in obesity rates among adults, but it is possible to prevent or delay metabolic syndrome, mainly with lifestyle changes. A healthy lifestyle is a lifelong commitment. Successfully controlling metabolic syndrome requires long-term effort and teamwork with your health care providers.

When changes in lifestyle alone do not control the conditions related to metabolic syndrome, your health practitioner may prescribe medications to control blood pressure, cholesterol, and other symptoms. Carefully following your practitioner’s instructions can help prevent many of the long-term effects of metabolic syndrome. Every step counts, and your hard work and attention to these areas will make a difference in your health.

If you live in the Las Vegas area and are looking for answers to obesity and metabolic syndrome problems, schedule a consultation with VIP Surg. Dr. Tsuda and Dr. Ryan and their team of experts can help find the right treatment for you.
 

Is Obesity a Disease?

Whether or not obesity should be considered a disease is a matter of debate. In 2013, the American Medical Association, the nation’s largest group of physicians, voted to recognize obesity as a disease. The decision was controversial to say the least.

The decision was meant to improve access to weight loss treatment, reduce the stigma of obesity, and underscore the fact that obesity is not always a matter of self-control. Others argue that calling obesity a disease automatically categorizes a large portion of Americans as “sick,” when they may not be. Instead, critics say obesity should be considered a risk factor for many diseases, but not a disease in and of itself.

Experts on one side of the issue say obesity, like alcoholism, depression, and anxiety, is a disease. There are definite medical patterns: hormone imbalances, neurotransmitter deficiencies, and nutritional exhaustion that all contribute to obesity. Many patients that are obese have underlying medical issues that need to be addressed.

On the other hand, with more than one third of the American population presently classified as obese, it is clear that there are many causes for excessive fat accumulation like genetic issues, too little exercise/physical activity, too much food, inappropriate food selection, eating while watching television, etc. In many cases, obesity is the result of a specific lifestyle which can typically be reversed (at least in the short term) by adopting a different lifestyle.

Obesity increases the risk of developing a number of serious health conditions, including:

  • Coronary heart disease
  • High blood pressure
  • Stroke
  • Type 2 diabetes
  • Cancer
  • Sleep apnea
  • Gallstones
  • Osteoarthritis
  • Infertility or irregular periods

The Center for Disease Control (CDC) says people should aim to make long-term changes, such as eating healthy on a regular basis, and boosting daily physical activity. Even small amounts of weight loss — such as 5% to 10% of your total body weight – can have health benefits.

For some, obesity as a disease invalidates the importance of discipline, proper nutrition, and exercise and enables individuals with obesity to escape responsibility. For others, obesity as a disease is a bridge to additional research, coordination of effective treatment, and increased resources for weight loss.

Ultimately, obesity is a complex entity that can have many causes; some are endocrine (like thyroid malfunction or hyperfunctioning of the adrenal gland or Cushing’s syndrome), but often the condition is from a combination of inactivity and overeating. For others, there are genetic factors that produce a tendency to be overweight even with the consumption of what would be for most people an appropriate number of calories. Whether the causes are hormonal, genetic, or reside in the brain is often difficult to determine.

If you’re in the Las Vegas area and looking for treatment for obesity and the life-threatening conditions that often accompany it, schedule an appointment with VIP Surg. Our experts can help you find the right treatment for your unique situation.

High Blood Pressure: Do these Things Now to Prevent Future Problems

Blood pressure is the force of blood against the walls of arteries, and it’s normal for it to rise and fall throughout the day. However, when blood pressure stays elevated over time, it’s called hypertension (aka high blood pressure). High blood pressure is dangerous because it makes the heart work too hard and contributes to atherosclerosis (hardening of the arteries). It increases the risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans. High blood pressure also can result in other conditions, such as congestive heart failure, kidney disease, and blindness. About two-thirds of people over age 65 have high blood pressure. This means that even if you don’t have high blood pressure now, you are likely to develop it in the future unless you adopt a healthy lifestyle.

  • Maintain a healthy weight – Being overweight or obese increases your risk of developing high blood pressure. In fact, your blood pressure rises as your body weight increases. Losing even 10 pounds can lower your blood pressure, and losing weight has the biggest effect on those who are overweight and already have hypertension.
  • Be physically active – Being physically active is one of the most important things you can do to prevent or control high blood pressure. Try to engage in physical activity for a total of 30 minutes on most days of the week. You can do this by combining everyday chores with moderate-level sporting activities, such as walking.
  • Follow a healthy eating plan – What you eat affects your chances of getting hightape-403593__340 blood pressure. A healthy eating plan can both reduce the risk of developing high blood pressure and lower a blood pressure that is already too high. An important part of healthy eating is choosing foods that are low in salt (sodium chloride) and other forms of sodium. Using less sodium is key to keeping blood pressure at a healthy level. Use spices, garlic, and onions to add flavor to your meals without adding more sodium. Set up a healthy eating plan with foods low in saturated fat,total fat, and cholesterol, and high in fruits, vegetables, and low-fat dairy foods.
  • Drink alcohol only in moderation – In addition to raising blood pressure, too much alcohol can add unneeded calories to your diet. If you drink alcoholic beverages, have only a moderate amount—one drink a day for women, two drinks a day for men.
  • Take prescribed medications as directed – If you need drugs to help lower your
    lood pressure, you still should follow the lifestyle changes mentioned above. Use notes and other reminders to help you remember to take your meds. Ask your family to help you with reminder phone calls and messages.

These are just a few of the relatively easy things you can do to help lower or prevent hypertension. Ultimately, keeping blood pressure at healthy levels can be quite difficult – especially if you are dealing with other severe health problems such as obesity and the issues that often accompany it. If you live in the Las Vegas area and are considering weight-loss surgery, schedule a consultation with VIP SURG. We can help find the right treatment for you.

Weight-loss Surgery Myths – Setting the Record Straight

If you are considering bariatric surgery, you’ve probably heard many of the popular myths. These run the gamut from horror stories to fairy tales. In reality, these procedures are neither as awful nor as fantastic as they’re made out to be. Here are some facts to help set the record straight about weight-loss surgery (WLS).

Myth: All bariatric surgery involves stomach stapling.

  • There are many different types of gastrointestinal procedures for weight loss, some of which reduce the functioning size of the stomach and others that bypass parts of the digestive tract, reducing absorption of calories and nutrients. Different types of surgeries offer different results, and some are more suitable for particular people than others.

Myth: People who get weight-loss surgery don’t have willpower.

  • Many bariatric surgery patients have struggled for years, pushing themselves to extremes to lose weight and keep it off. They understand that surgery is a final option when everything else has failed. The surgery, recovery and lifestyle changes that accompany WLS require both courage and determination on the part of the patient.

Myth:  Bariatric surgery is only for the morbidly obese.

  • Obesity is only one of the criteria that qualify patients for surgery. Overweight patients may also be candidates if they have one or more health problems that might be reduced or alleviated by weight loss such as diabetes, sleep apnea, hypertension, arthritis, and high cholesterol.

Myth: Bariatric surgery is extremely dangerous.

  • Any type of surgery has associated risks, such as complications or even death. However, a number of recent advances have helped to minimize risks. Surgeries are usually done laparoscopically with mini-incisions that result in faster healing, less pain, and less scarring.

Myth: You will finally be skinny after bariatric surgery.

  • Losing just 50% of excess weight and keeping it off is considered a success story. That’s still going to be overweight in the eyes of most people. Plus, your skin isn’t necessarily going to tone up and be free of drooping after weight loss. However, the health benefits in reducing weight-related problems like sleep apnea often occur even in patients who don’t lose all the weight they would like.

Myth: Weight loss from bariatric surgery is permanent.

  • Unfortunately, even this one is not true. In fact, some regain is likely. Part of this is simply the body adjusting and learning to store fat even on a very restricted diet. At other times, a patient’s failure to adhere to the post-surgery lifestyle recommendations plays a role.

Myth: You should only have WLS if you are done having kids.

  • It isn’t safe to get pregnant in the first year or two after bariatric surgery. You simply won’t be getting enough nutrients to support a growing fetus. After you are done losing weight (if you are taking all your supplements and monitoring your health carefully), getting pregnant should be okay. This is something to discuss with your bariatric surgeon.

Myth: After bariatric surgery, you won’t be able to eat anything that tastes good.

  • Patients who undergo gastric bypass may need to avoid very sweet foods because it can cause side effects like dizziness and nausea. Patients who have a duodenal switch typically need to keep fatty foods to a minimum. However, many patients can and do eat their favorite foods after they recover from surgery. They just eat very small portions.

Myth: You can never be far from a bathroom after WLS.

  • In the aftermath of surgery, you may find yourself having some “emergency” bathroom visits. However, symptoms like diarrhea and vomiting should subside over time as you get a better handle on how your altered digestive system responds to food.

Myth: Bariatric surgery is reversible.

  • Gastric banding is usually reversible. That’s because the stomach and intestines are not cut or stapled with this surgery. Gastric bypass may be reversible, but this is a very involved surgery. It’s more difficult to put everything back where it was, and there is a risk that the revision won’t restore normal function. Sleeve gastrectomy and duodenal switch entail actual removal of part of the stomach without reattaching it lower on the intestine. This type of surgery is not reversible.

Surgery for weight reduction is not a miracle procedure. Weight loss surgery is designed to assist the morbidly obese in developing a healthier lifestyle. A surgical weight loss operation is a useful tool for weight loss, but it is a surgical procedure that requires a substantial lifelong commitment. The surgery alone will not help someone lose weight and keep it off. The patient must change eating and exercise habits. Without changes to the daily pattern of eating and activity, the patient is likely to regain the weight over time.