Factors associated with hypertension remission after gastrectomy for gastric cancer patients

Table 1 Baseline characteristics of the remission group and the non-remission group

Characteristics	Remission (n = 108)	Non-remission (n = 101)	P value
Age (yr)	63.6 ± 8.7	67.4 ± 8.0	0.001b
Sex			0.420
Male	70 (64.8)	60 (59.4)
Female	38 (35.2)	41 (40.6)
Pre-operative BMI (kg/m2)	23.4 ± 3.0	23.3 ± 32.9	0.770
Pre-operative weight (kg)	63.1 ± 10.0	61.9 ± 10.1	0.366
Pre-operative albumin (g/L)	39.5 ± 5.9	39.4 ± 5.3	0.902
Pre-operative hemoglobin (g/L)	117.9 ± 28.5	118.3 ± 24.4	0.922
Weight loss (kg)	-8.2 ± 6.7	-5.6 ± 4.6	0.001b
Smoking	39 (36.1)	41 (40.6)	0.923
Drinking	44 (40.7)	31 (30.7)	0.130
T2DM	21 (19.4)	19 (18.8)	0.908
CHD	9 (8.3)	20 (19.8)	0.017a
Hypertension classification			0.033a
I	27 (25.0)	25 (24.8)
II	51 (47.2)	32 (31.7)
III	30 (27.8)	44 (43.6)
Neoadjuvant chemotherapy	7 (6.5)	7 (6.9)	0.897
Surgical techniques			0.008b
Subtotal gastrectomy	74 (68.5)	85 (84.2)
Total gastrectomy	34 (31.5)	16 (15.8)
Reconstruction methods			0.771
B-I	37 (34.3)	36 (35.6)
B-II	15 (13.9)	17 (16.8)
R-Y	56 (51.8)	48 (47.6)
Tumor stage			0.174
I	37 (34.3)	36 (35.6)
II	15 (13.9)	17 (16.8)
III	56 (51.8)	48 (47.6)
Tumor size			0.556
< 5 cm	92 (85.2)	83 (82.2)
≥ 5 cm	16 (14.8)	18 (17.8)
Hypertension duration			0.346
≤ 5 yr	53 (49.1)	43 (42.6)
> 5 yr	55 (50.9)	58 (57.4)

^aP < 0.05.

^bP < 0.01.

Variables are expressed as the mean ± SD, n (%). T2DM: Type 2 diabetes mellitus; BMI: Body mass index; CHD: Coronary heart disease; B-I: Billroth I reconstruction; B-II: Billroth II reconstruction; R-Y: Roux-en-Y reconstruction.

Table 2 Univariate and multivariate logistic regression of hypertension remission

Risk factors	Univariate analysis		Multivariate analysis
	OR (95%CI)	P value	OR (95%CI)	P value
Age (yr)	0.947 (0.916-0.980)	0.002b	0.955 (0.922-0.990)	0.011a
Sex (male/female)	0.794 (0.454-1.391)	0.421
Pre-operative BMI (kg/m2)	1.014 (0.925-1.112)	0.769
Pre-operative weight (kg)	1.013 (0.986-1.040)	0.365
Pre-operative albumin (g/L)	1.003 (0.956-1.053)	0.902
Pre-operative hemoglobin (g/L)	0.999 (0.989-1.010)	0.922
Weight loss (kg)	0.922 (0.875-0.971)	0.002b	0.937 (0.887-0.989)	0.019a
Smoking (yes/no)	0.973 (0.557-1.700)	0.923
Drinking (yes/no)	1.552 (0.877-2.748)	0.131
T2DM (yes/no)	1.042 (0.523-2.077)	0.908
CHD (yes/no)	0.368 (0.159-0.853)	0.020a	0.517 (0.212-1.265)	0.148
Hypertension classification (III/II/I)	0.761 (0.533-1.087)	0.133
Neoadjuvant chemotherapy (yes/no)	0.931 (0.315-2.753)	0.897
Surgical techniques (Total gastrectomy/subtotal gastrectomy)	2.441 (1.248-4.775)	0.009b	2.091 (1.037-4.216)	0.039a
Reconstruction methods (R-Y/B-II/B-I)	1.318 (0.968-1.794)	0.080
Tumor stage (III/II/I)	1.072 (0.795-1.445)	0.650
Tumor size (≥ 5 cm/< 5 cm)	0.802 (0.384-1.674)	0.557
Hypertension duration (> 5 yr/≤ 5 yr)	0.769 (0.446-1.328)	0.346

^aP < 0.05.

^bP < 0.01.

OR: Odds ratio; CI: Confidence interval; T2DM: Type 2 diabetes mellitus; BMI: Body mass index; CHD: Coronary heart disease; B-I: Billroth I reconstruction; B-II: Billroth II reconstruction; R-Y: Roux-en-Y reconstruction.

Table 3 Previous studies reporting the remission of hypertension after gastrectomy for gastric cancer patients

Ref.	Year	Country	Sample size	Remission rate	Summary
Peng et al[15]	2020	China	143	55.3%	Age and the surgical techniques used can predict the remission of hypertension 6 mo after gastrectomy. However, the follow-up time was only 6 mo
Kim et al[16]	2019	South Korea	66	57.6%	In early gastric cancer survivors with hypertension, gastrectomy resulted in better blood pressure control, which may be due to the gastrectomy itself, beyond weight loss
Lee et al[17]	2015	South Korea	351	11.1%	The results came from a nationwide cohort study with limited baseline information, no further information could be found in terms of risk factors for hypertension remission
Park et al[18]	2020	South Korea	33	42.4%	The study focused on the comparison between the long-limb R-Y reconstruction between conventional R-Y reconstruction, the information for hypertension remission was limited
Wang et al[19]	2020	China	16	93.8%	Elaborate parameters of endocrine hormone change, however, the sample size was too small