GAstric Bypass to Treat obEse Patients With steAdy hYpertension — GATEWAY  

Obesity Clinical Trial

Official title: Phase 3 Randomized Controlled Trial Evaluating the Effect of Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) on Hypertension Medication Reduction, Blood Pressure Levels and Others Cardiovascular Risk Factors.

Status Completed

Clinical Trial Summary

Phase 3, unicentric, randomized clinical trial, with allocation concealment and intention-to-treat analysis to evaluate the efficacy of videolaparoscopic Roux-en-Y Gastroplasty to decrease the prescription of antihypertensive drugs maintaining normal levels of blood pressure, decrease systemic arterial blood pressure and other risk factors for cardiovascular events compared to clinical treatments of patients with arterial hypertension.

Clinical Trial Description

Randomization:

The randomization list is electronically generated through specific software. A block randomization is conducted with varying block sizes at the rate of 1:1. Confidentiality of the randomization list is ensured by the central automated randomization system, through the Internet, available 24 hours a day (ACT Clinic - Sistema de Estudos Clínicos do IEP HCor).

Blinding Scheme:

Because the study involves a surgical procedure, investigators and patients cannot be blind for treatment allocated to patients.

Roux-en-Y Gastroplasty Patients allocated to surgical treatment will be admitted to the hospital to be subjected to a Roux-en-Y gastric bypass with a biliopancreatic loop of 100cm and a alimentary limb of 150cm.

Antihypertensive Treatment:

The treatment of hypertension will be standardized for all study patients. Prescribed drugs will include preferably a renin-angiotensin blocking system drug and a calcium channels blocker, except if these are contraindicated or the patient has achieved good blood pressure control using other drugs prior to study recruitment. Other drugs can be added at discretion of the attending investigator to achieve a target blood pressure of 130 x 80 mmHg. Patients are treated individually for the other associated comorbidities. Obesity treatment in the control group includes dietary advice, motivation for the practice of physical activities, and drug treatments for diabetes and dyslipidemias if applicable.

Laboratory tests and other exams:

All patients will be subjected to the following measurements throughout the study:

• Outpatient Blood Pressure Monitoring (ABPM)

• Blood pressure measurements taken in doctors' offices:

• Central pressure and associated measurements (SphygmoCor®)

• Polysomnography

• Anthropometry

• Nutritional survey

• Laboratory tests

• Echocardiogram

• Electrocardiogram

• Abdominal ultrasound

• Upper gastrointestinal endoscopy with H.pylori testing ;

Related Conditions & MeSH terms

• Hypertension
• Obesity
• Systemic Hypertension

• NCT number: NCT01784848
• Study type: Interventional
• Source: Hospital do Coracao
• Status: Completed
• Phase: N/A
• Start date: May 2013
• Completion date: February 2022