Discontinuation of blood pressure-lowering, glucose-lowering, and lipid-lowering medications following bariatric surgery: A nationwide cohort study in South Korea

Surgery for Obesity and Related Diseases(2024)

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Abstract
Background Limited evidence exists on the pattern of medication use for hypertension, diabetes mellitus (DM), and dyslipidemia after bariatric surgery among Asian patients. Objective To investigate the pattern in the use of blood pressure-lowering-, glucose-lowering-, and lipid-lowering medications following BS in Korean patients with morbid obesity. Setting This study is a retrospective cohort study using the Health Insurance Review and Assignment claims database of South Korea (from 2019 to 2021). Methods We included patients who underwent BS between 2019 and 2020 in South Korea. We evaluated the treatment pattern of blood pressure-lowering-, glucose-lowering-, and lipid-lowering medications at 3-month intervals for 1-year following BS, including medication use, individual medication classes, and the number of medications prescribed. Further, we estimated remission rates for each disorder based on patient characteristics by defining patients who discontinued their medications for at least two consecutive quarters as remission. Results A total of 3,810 patients were included in this study. For 1-year following BS, a marked decrease in the number of patients using blood pressure-lowering-, glucose-lowering-, and lipid-lowering medications was observed. The most remarkable decrease occurred in glucose- lowering medications, which decreased by approximately −75.1% compared with that at baseline. This tendency was consistently observed when analyzing both the number of medications prescribed and the specific medication classes. Regarding remission rates, patients who were female, younger, and received the biliopancreatic diversion-duodenal switch as their BS showed a relatively higher incidence of remission than other groups. Conclusion BS was associated with a decrease in the use of medications for hypertension, DM, and dyslipidemia.
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Key words
Bariatric surgery,hypertension,diabetes mellitus,dyslipidemia,medication discontinuation
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