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Bariatric surgery also cuts CV risk

By Matthew C. Wiencke

Bariatric surgery leaves patients with a smaller stomach and a smaller risk of suffering a cardiovascular (CV) event, found a recent study. DMS's John Batsis, M.D., was the lead author of the paper, which showed that the long-term risk of a CV event-such as a heart attack-is likely to drop substantially after bariatric surgery.

The procedure's main goal is to help people lose excess weight if they've been unable to do so through diet and exercise; it involves partitioning off and/or bypassing part of the stomach.

Factors: Batsis says other researchers had recently concluded that factors which affect an individual's likelihood of experiencing a CV event-such as diabetes, hypertension, and high cholesterol-improved after bariatric surgery. "But," he says, "no one had really ascertained whether or not CV risk changed."

So he and colleagues did a reanalysis of existing data from six previously published clinical trials of bariatric surgery and calculated the 10-year risk of the subjects having a CV event. They found that across all six studies-which were conducted in Italy, Mexico, New Zealand, Sweden, and the U.S.-bariatric surgery reduced the risk of a CV event between 8% and 79%. In the U.S. study, subjects' CV risk after surgery fell 50% (from 7% to 3.5%), whereas the risk of patients in the nonsurgical group declined just 8% (from 7.1% to 6.5%).

Rise: All six studies followed subjects for a minimum of one year, but only one had actual 10-year follow-up data. That study, from Sweden, found that both surgical and nonsurgical patients' CV risk increased after 10 years. But the risk rose significantly more in the nonsurgical than the surgical group. The overall rise, Batsis thinks, was due to the patients aging. "Just the incremental increase of a 10-year period to age," he says, "increases your cardiac risk." He did the actual research while he was a fellow at

the Mayo Clinic and published the results in the American Journal of Cardiology after coming to DMS.

The study has "a lot of public health implications," notes Batsis, since over a third of U.S. adults-some 72 million people-are obese. For those who choose bariatric surgery, he says, "over time [their] predicted cardiac risk is likely decreasing."

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