Weight loss after bariatric surgery improves patients' cardiovascular risk profile, a systematic review of the medical literature confirms.
"The bariatric community has recognized the remarkable metabolic benefits of weight loss surgery for several years, so we were not too surprised by the findings reported in this study," said lead investigator Dr. Helen M. Heneghan in an email to Reuters Health.
"However, these findings may surprise cardiologists and physicians who treat obese patients for weight-related illnesses on a daily basis, yet are less familiar with the dramatic metabolic effects of bariatric surgery."
Dr. Heneghan, from Ohio's Cleveland Clinic, and colleagues reviewed 52 studies involving 16,867 patients who had bariatric procedures.
Weight loss after bariatric surgery averaged 52% of excess weight, according to a report of their findings published online August 30th in the American Journal of Cardiology.
Excess weight loss was greater after Roux-en-Y gastric bypass (65%) and biliopancreatic diversion (69%) than after laparoscopic gastric banding (42%).
The Framingham risk score (reported in 3 studies) decreased significantly after bariatric surgery, from 6.3% preoperatively to 3.8% postoperatively, representing a 40% relative risk reduction for 10-year coronary heart disease risk.
Postoperatively, patients had remission or resolution of hypertension in 68% of cases, diabetes in 75%, and dyslipidemia in 71%, with improvements seen as early as three months and persisting through up to 155 months of follow-up.
Bariatric surgery and weight loss were also associated with reductions in systolic and diastolic blood pressure, improvements in lipid profile, and decreases in fasting blood glucose and glycosylated hemoglobin.
In the only study that reported cardiovascular mortality, bariatric surgery appeared to cut by half the rate of mortality secondary to myocardial infarctions, from 1.2% to 0.65%.
"We hope that after reading this (systematic review), physicians will recognize that their obese patients with cardiovascular risk factors or established cardiovascular disease would benefit immensely from weight loss surgery," Dr. Heneghan said.
"We would like to encourage all health care providers to seek more information on the benefits of bariatric surgery and would like to direct them to the bibliography of our article, which contains many important references in this field," she added. "Furthermore, we hope that physicians will collaborate with their surgical colleagues in conducting prospective studies, further examining the cardiovascular and other metabolic effects of surgically-induced weight loss in the morbidly obese."
Two of the five authors of this study reported financial associations with companies that manufacture equipment used in bariatric surgery.
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