Bariatric Surgery Linked to Cardiovascular Improvements in People with Severe Obesity

Bariatric surgery may result in significant cardiometabolic improvements, particularly among younger, female, or white people and those without comorbidities, according to new research published in the Journal of the Endocrine Society.

The United States has the highest obesity rates globally. In 2017 – 2018, about 40% of U.S. adults had obesity and 9% had severe obesity. The prevalence is particularly high among Black adults. Bariatric surgery is one method to help people with severe obesity lose a lot of weight and improve their health.

“Our study highlights how bariatric surgery not only leads to significant weight loss but also substantially improves heart health,” says study author Lei Wang, MPhil, of Vanderbilt University Medical Center in Nashville, Tenn. “These health benefits include lower blood pressure, blood lipids, and blood sugar, and an estimated 35% reduction in 10-year cardiovascular disease risk one year after surgery.”

“Our findings can help people with severe obesity experience better health outcomes and help us recognize which patients may require extra health management after surgery.”

Lei Wang, MPhil, Vanderbilt University Medical Center, Nashville, Tenn.

“Additionally, 30% to 50% of people in our study experienced remissions of diabetes, hypertension and dyslipidemia,” adds co-author Danxia Yu, PhD, also at Vanderbilt University Medical Center. “Individuals who were younger, female, self-identified as white and had no history of cardiometabolic diseases tended to see greater post-surgery cardiometabolic improvements.”

The researchers analyzed over 7,800 people between the ages of 20 to 79 who underwent bariatric surgery during 1999-2022 at the Vanderbilt University Medical Center. Most study participants were women and white, but the study also includes a significant number of male patients and Black patients, who have been underrepresented in bariatric surgery research.

The researchers evaluated various cardiometabolic improvements, including blood pressure, cholesterol, glucose and HbA1c. They also measured remission rates of diabetes, hypertension and dyslipidemia, and the estimated 10-year cardiovascular disease risk.

Older, male or Black patients showed less reduction in 10-year heart disease risk and lower odds of diabetes, hypertension and dyslipidemia remission than younger, female or white patients. Patients with a history of diabetes, hypertension, dyslipidemia or cardiovascular disease showed less cardiometabolic improvements than those without.

“Our findings can help people with severe obesity experience better health outcomes and help us recognize which patients may require extra health management after surgery,” Wang says.

Other study authors include Xiao-Ou Shu, You Chen, Brandon Williams, Matthew Spann, Charles Flynn and Wayne English of Vanderbilt University Medical Center; Michael O’Brien and Xinmeng Zhang of Vanderbilt University in Nashville, Tenn.; and Vance Albaugh of Metamor Institute, Pennington Biomedical Research Center, in Baton Rouge, La.

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases.

The manuscript, “Cardiometabolic Improvements After Metabolic Surgery and Related Pre-surgery Factors,” was published online.

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