Effect of bariatric surgery on cardiometabolic risk in elderly patients: A population-based study

John A. Batsis, William R. Miranda, Chaithra Prasad, Maria L. Collazo-Clavell, Michael G. Sarr, Virend Somers, Francisco Lopez-Jimenez

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Aim: Obesity is a major cardiovascular (CV) risk factor. Bariatric surgery (BSx) is an approved therapeutic alternative for classII-III obesity, but little evidence focuses on older adults. We assessed the effect of BSx on cardiometabolic variables and long-term CV risk in older adults. Methods: We carried out a population-based, observational study from 1990-2009, of 40 consecutive elderly (age ≥60 years) residents of Olmsted County, MN, USA, with classII-III obesity treated with BSx at a University-based, academic health center. Data were obtained from the Rochester Epidemiology Project. Metabolic syndrome (MetS) was defined using American Heart Association/National Heart, Lung, Blood Institute (AHA/NHLBI) criteria (increased triglycerides, low high-density lipoprotein, increased blood pressure, increased glucose and body mass index as a modified measure of obesity instead of waist circumference). Change in CV risk factors, MetS prevalence, and impact on predicted CV risk using the Framingham risk score was ascertained at 1 year postoperatively and assessed statistically. Results: Mean age and body mass index were 64.4±3.7 and 45.0±6.3kg/m<sup>2</sup>, respectively, and 28 out of 40 (70%) were women. One participant died during the 11-month study period after BSx from respiratory complications related to BSx, and one participant died at 2 years. Percentage of excess weight loss decreased by 57.5% at 1 year. Prevalence 1 year after BSx decreased for diabetes (57.5% to 22.5%; P<0.03), hypertension 87.5% to 73.7% (P=0.003), dyslipidemia (80% to 42.5%; P<0.001) and sleep apnea (62.5% to 23.7%; P<0.001).MetS prevalence decreased from 80% to 45% (P<0.002). Baseline risk was 14.1%, which changed at follow up at 8.2%. Conclusions: In older adults, BSx induces considerable weight loss, improves CV risk factors, decreases MetS prevalence and is an effective treatment in this population.

Original languageEnglish (US)
JournalGeriatrics and Gerontology International
DOIs
StateAccepted/In press - 2015

Fingerprint

Bariatric Surgery
surgery
Obesity
Population
Weight Loss
Body Mass Index
National Heart, Lung, and Blood Institute (U.S.)
Sleep Apnea Syndromes
Waist Circumference
HDL Lipoproteins
Dyslipidemias
LDL Lipoproteins
Observational Studies
Epidemiology
Triglycerides
Blood Pressure
Hypertension
Glucose
hypertension
epidemiology

Keywords

  • Bariatric surgery
  • Elderly
  • Framingham risk
  • Metabolic risk

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Gerontology
  • Health(social science)

Cite this

Effect of bariatric surgery on cardiometabolic risk in elderly patients : A population-based study. / Batsis, John A.; Miranda, William R.; Prasad, Chaithra; Collazo-Clavell, Maria L.; Sarr, Michael G.; Somers, Virend; Lopez-Jimenez, Francisco.

In: Geriatrics and Gerontology International, 2015.

Research output: Contribution to journalArticle

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abstract = "Aim: Obesity is a major cardiovascular (CV) risk factor. Bariatric surgery (BSx) is an approved therapeutic alternative for classII-III obesity, but little evidence focuses on older adults. We assessed the effect of BSx on cardiometabolic variables and long-term CV risk in older adults. Methods: We carried out a population-based, observational study from 1990-2009, of 40 consecutive elderly (age ≥60 years) residents of Olmsted County, MN, USA, with classII-III obesity treated with BSx at a University-based, academic health center. Data were obtained from the Rochester Epidemiology Project. Metabolic syndrome (MetS) was defined using American Heart Association/National Heart, Lung, Blood Institute (AHA/NHLBI) criteria (increased triglycerides, low high-density lipoprotein, increased blood pressure, increased glucose and body mass index as a modified measure of obesity instead of waist circumference). Change in CV risk factors, MetS prevalence, and impact on predicted CV risk using the Framingham risk score was ascertained at 1 year postoperatively and assessed statistically. Results: Mean age and body mass index were 64.4±3.7 and 45.0±6.3kg/m2, respectively, and 28 out of 40 (70{\%}) were women. One participant died during the 11-month study period after BSx from respiratory complications related to BSx, and one participant died at 2 years. Percentage of excess weight loss decreased by 57.5{\%} at 1 year. Prevalence 1 year after BSx decreased for diabetes (57.5{\%} to 22.5{\%}; P<0.03), hypertension 87.5{\%} to 73.7{\%} (P=0.003), dyslipidemia (80{\%} to 42.5{\%}; P<0.001) and sleep apnea (62.5{\%} to 23.7{\%}; P<0.001).MetS prevalence decreased from 80{\%} to 45{\%} (P<0.002). Baseline risk was 14.1{\%}, which changed at follow up at 8.2{\%}. Conclusions: In older adults, BSx induces considerable weight loss, improves CV risk factors, decreases MetS prevalence and is an effective treatment in this population.",
keywords = "Bariatric surgery, Elderly, Framingham risk, Metabolic risk",
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T1 - Effect of bariatric surgery on cardiometabolic risk in elderly patients

T2 - A population-based study

AU - Batsis, John A.

AU - Miranda, William R.

AU - Prasad, Chaithra

AU - Collazo-Clavell, Maria L.

AU - Sarr, Michael G.

AU - Somers, Virend

AU - Lopez-Jimenez, Francisco

PY - 2015

Y1 - 2015

N2 - Aim: Obesity is a major cardiovascular (CV) risk factor. Bariatric surgery (BSx) is an approved therapeutic alternative for classII-III obesity, but little evidence focuses on older adults. We assessed the effect of BSx on cardiometabolic variables and long-term CV risk in older adults. Methods: We carried out a population-based, observational study from 1990-2009, of 40 consecutive elderly (age ≥60 years) residents of Olmsted County, MN, USA, with classII-III obesity treated with BSx at a University-based, academic health center. Data were obtained from the Rochester Epidemiology Project. Metabolic syndrome (MetS) was defined using American Heart Association/National Heart, Lung, Blood Institute (AHA/NHLBI) criteria (increased triglycerides, low high-density lipoprotein, increased blood pressure, increased glucose and body mass index as a modified measure of obesity instead of waist circumference). Change in CV risk factors, MetS prevalence, and impact on predicted CV risk using the Framingham risk score was ascertained at 1 year postoperatively and assessed statistically. Results: Mean age and body mass index were 64.4±3.7 and 45.0±6.3kg/m2, respectively, and 28 out of 40 (70%) were women. One participant died during the 11-month study period after BSx from respiratory complications related to BSx, and one participant died at 2 years. Percentage of excess weight loss decreased by 57.5% at 1 year. Prevalence 1 year after BSx decreased for diabetes (57.5% to 22.5%; P<0.03), hypertension 87.5% to 73.7% (P=0.003), dyslipidemia (80% to 42.5%; P<0.001) and sleep apnea (62.5% to 23.7%; P<0.001).MetS prevalence decreased from 80% to 45% (P<0.002). Baseline risk was 14.1%, which changed at follow up at 8.2%. Conclusions: In older adults, BSx induces considerable weight loss, improves CV risk factors, decreases MetS prevalence and is an effective treatment in this population.

AB - Aim: Obesity is a major cardiovascular (CV) risk factor. Bariatric surgery (BSx) is an approved therapeutic alternative for classII-III obesity, but little evidence focuses on older adults. We assessed the effect of BSx on cardiometabolic variables and long-term CV risk in older adults. Methods: We carried out a population-based, observational study from 1990-2009, of 40 consecutive elderly (age ≥60 years) residents of Olmsted County, MN, USA, with classII-III obesity treated with BSx at a University-based, academic health center. Data were obtained from the Rochester Epidemiology Project. Metabolic syndrome (MetS) was defined using American Heart Association/National Heart, Lung, Blood Institute (AHA/NHLBI) criteria (increased triglycerides, low high-density lipoprotein, increased blood pressure, increased glucose and body mass index as a modified measure of obesity instead of waist circumference). Change in CV risk factors, MetS prevalence, and impact on predicted CV risk using the Framingham risk score was ascertained at 1 year postoperatively and assessed statistically. Results: Mean age and body mass index were 64.4±3.7 and 45.0±6.3kg/m2, respectively, and 28 out of 40 (70%) were women. One participant died during the 11-month study period after BSx from respiratory complications related to BSx, and one participant died at 2 years. Percentage of excess weight loss decreased by 57.5% at 1 year. Prevalence 1 year after BSx decreased for diabetes (57.5% to 22.5%; P<0.03), hypertension 87.5% to 73.7% (P=0.003), dyslipidemia (80% to 42.5%; P<0.001) and sleep apnea (62.5% to 23.7%; P<0.001).MetS prevalence decreased from 80% to 45% (P<0.002). Baseline risk was 14.1%, which changed at follow up at 8.2%. Conclusions: In older adults, BSx induces considerable weight loss, improves CV risk factors, decreases MetS prevalence and is an effective treatment in this population.

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KW - Elderly

KW - Framingham risk

KW - Metabolic risk

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