Effect of weight loss on predicted cardiovascular risk: Change in cardiac risk after bariatric surgery

John A. Batsis, Abel Romero-Corral, Maria L. Collazo-Clavell, Michael G. Sarr, Virend K. Somers, Lee Brekke, Francisco Lopez-Jimenez

Research output: Contribution to journalArticlepeer-review

58 Scopus citations

Abstract

Objective: Our goal was to assess the effect of bariatric surgery on cardiovascular risk estimations of preventable, long-term adverse outcomes. Research Methods and Procedures: We performed a population-based, historical cohort study between 1990 and 2003 of 197 consecutive patients from Olmsted County, MN, with Class II to III obesity (defined as BMI ≥35 kg/m 2) treated with Roux-en-Y gastric bypass and 163 non-operative patients assessed in a weight-reduction program. We used the observed change in cardiovascular risk factors and risk models derived from data from the National Health and Nutrition Examination Survey (NHANES) I and the NHANES I Epidemiological Follow-up Study (NHEFS) to calculate the predicted impact on cardiovascular events and mortality for the operative and non-operative groups. Results: Mean follow-up was 3.3 years. Hypertension, diabetes, and dyslipidemia all improved after bariatric surgery. The estimated 10-year risk for cardiovascular events for the operative group decreased from 37% at baseline to 18% at follow-up, while the estimated risk for the non-operative group did not change from 30% at baseline to 30% at follow-up. Risk modeling to predict 10-year out-comes estimated 4 overall deaths and 16 cardiovascular events prevented by bariatric surgery per 100 patients compared with the non-operative group. Conclusions: Bariatric surgery induces an improvement in cardiovascular risk factors in patients with Class II to III obesity. Weight loss predicts a major, 10-year reduction in cardiovascular events and deaths. Bariatric surgery should be considered as an alternative approach to reduce cardio-vascular risk in patients with Class II to III obesity.

Original languageEnglish (US)
Pages (from-to)772-784
Number of pages13
JournalObesity
Volume15
Issue number3
DOIs
StatePublished - Mar 2007

Keywords

  • Bariatric surgery
  • Cardiovascular risk
  • Mortality
  • Population studies

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Endocrinology
  • Nutrition and Dietetics

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