Stenberg E, Marsk R, Sundbom M, et al. - Not delaying metabolic surgery in patients with severe obesity and hypertension is recommended because metabolic surgery yields the highest success rate for patients early in the course of disease.

• An association of metabolic surgery with remission of diabetes and hypertension has been documented in several studies.

• This nationwide observational study involved 15,984 patients with hypertension receiving a primary metabolic procedure.

• Remission of hypertension 2 years post-surgery was evident in almost 40% of patients with hypertension.

• Over 10-year follow-up, relapse occurred in 56%, a lower probability for major adverse cardiovascular events [2.8% vs 5.7%, adjusted odds ratio (OR) 0.60], and all-cause mortality [4.0% vs 8.0%, adjusted OR 0.71] was observed in those who reached remission vs those who did not reach remission.

• Better chance of remission was present in relation to high postoperative weight loss and male gender, while there was a lower chance of remission based on disease severity and presence of other metabolic comorbidities.