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Impact of Bariatric Surgery on Long-term Cardiovascular Risk: Comparative Effectiveness of Different Surgical Procedures

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Abstract

Introduction

Several reports highlight bariatric surgery as an efficient and long-lasting strategy for weight loss. Herein, we aimed to evaluate the impact of bariatric surgery on 10-year cardiovascular disease (CVD) risk and to compare the effectiveness of different surgical procedures, employing the Framingham Risk Score (FRS).

Methods

Retrospective longitudinal observational study of patients undergoing bariatric surgery. Data was assessed preoperatively and during a 4-year follow-up period.

Results

We evaluated 1449 individuals, 85.2% female, age of 42.4 ± 10.6 years, and preoperative BMI of 44.3 ± 5.8 kg/m2; 58.0% underwent Roux-en-Y gastric bypass (RYGB), 23.4% sleeve gastrectomy (SG), and 18.6% adjustable gastric band (AGB). The 10-year CVD risk decreased 43.6% in the first postoperative year. The decrease in FRS was more pronounced in the RYGB group (50.5% in the first postoperative year) (p < 0.001). Although there was a subsequent slight increase in FRS during the follow-up period, the cardiovascular benefits were maintained when compared with baseline. For all surgical procedures, CVD risk showed a quadratic trend with a J-shaped curve. A negative interaction between the RYGB group CVD risk and time was observed (β = − 0.072 (95% CI, − 0.109; − 0.035)). In the RYGB group, FRS decreased more when compared with the SG and AGB groups and, from the second postoperative year onwards, increased more slowly, regardless of gender. The SG group showed similar trend as that of the AGB (β = − 0.002 (95% CI, − 0.049; 0.053)).

Conclusion

Our study showed a significant reduction of 10-year CVD risk after bariatric surgery. This decrease was more pronounced in the first postoperative year, and RYGB was the procedure with the greatest decrease of the 10-year CVD risk.

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Acknowledgments

We would like to acknowledge all the endocrinologists, surgeons, and nutritionists of the Multidisciplinary Group for Surgical Management of Obesity.

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Authors and Affiliations

  1. Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário de São João, Porto, Portugal

    Sofia Castro Oliveira, J. S. Neves, P. Souteiro, J. Pedro, D. Magalhães, V. Guerreiro, R. Bettencourt-Silva, M. M. Costa, A. Varela, P. Freitas & D. Carvalho

  2. Faculty of Medicine, University of Porto, Porto, Portugal

    Sofia Castro Oliveira, J. S. Neves, P. Souteiro, J. Pedro, D. Magalhães, V. Guerreiro, R. Bettencourt-Silva, M. M. Costa, A. Varela, P. Freitas & D. Carvalho

  3. Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal

    Sofia Castro Oliveira, J. S. Neves, P. Souteiro, J. Pedro, D. Magalhães, V. Guerreiro, R. Bettencourt-Silva, M. M. Costa, P. Freitas & D. Carvalho

  4. Multidisciplinary Group for Surgical Management of Obesity, Centro Hospitalar Universitário de São João, Porto, Portugal

    A. Varela & P. Freitas

  5. Department of Clinical Pathology, Centro Hospitalar Universitário de São João, Porto, Portugal

    I. Barroso

  6. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal

    I. Barroso

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  1. Sofia Castro Oliveira
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AMTCO Group

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Correspondence to Sofia Castro Oliveira.

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All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Oliveira, S.C., Neves, J.S., Souteiro, P. et al. Impact of Bariatric Surgery on Long-term Cardiovascular Risk: Comparative Effectiveness of Different Surgical Procedures. OBES SURG 30, 673–680 (2020). https://doi.org/10.1007/s11695-019-04237-0

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