Reduction in Predicted Coronary Heart Disease Risk After Substantial Weight Reduction After Bariatric Surgery

Vogel, Jody A.; Franklin, Barry A.; Zalesin, Kerstyn C.; Trivax, Justin; Krause, Kevin R.; Chengelis, David L.; McCullough, Peter A.

doi:10.1016/j.amjcard.2006.08.017

Cited by 97 publications

(62 citation statements)

References 22 publications

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“…Given that coronary heart disease is a leading cause of mortality in adults in the United States 103 and that bariatric surgery results in a substantial improvement in coronary heart disease risk factors, the effect of bariatric surgery on the projected risk for coronary heart disease has been evaluated by several authors. 104,105 Using the Framingham risk score to estimate the postoperative reduction in 10-year risk for coronary heart disease, Vogel and colleagues 104 demonstrated that the risk of coronary heart disease decreased by 39% in men and 25% in women, with an overall decrease in predicted 10-year risk for coronary heart disease from 6% (SD 5%) and 4% (SD 3%), respectively (p < 0.001). In addition, subgroup analysis demonstrated that for those without coronary heart disease, men compared favourably with the age-matched general population, with a final 10-year risk of 5% (SD 4%) versus an expected risk of 11% (SD 6%; p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

Biological effects of bariatric surgery on obesity-related comorbidities

2013

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Section: Resultsmentioning

confidence: 99%

Biological effects of bariatric surgery on obesity-related comorbidities

2013

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“…32 Bariatric treatments showed to give greater benefits in terms of weight reduction and of diabetes resolution compared with medical therapies 33,34 and to strongly reduce CHD risk 10 and overall mortality. [35][36][37] On long-term period, there are no trials comparing matched patients treated by malabsorptive and by restrictive procedures.…”

Section: Discussionmentioning

confidence: 99%

“…7 After bariatric treatment, resolution of hyperglycemia in a very high percentage of cases is reported; 8,9 the predicted risk of CHD decreases to rates lower than age-and gender-adjusted estimates for the general population, suggesting that weight loss may be a preventive shunting to reduce myocardial infarction and death rate in obese subjects. 10 Hyperlipidemia is strongly improved by some surgical procedures. 11 Considering the very low postoperative mortality, 12 surgery seems to represent a valid approach to treat obesity and related diseases.…”

Section: Introductionmentioning

confidence: 99%

Metabolic or bariatric surgery? Long-term effects of malabsorptive vs restrictive bariatric techniques on body composition and cardiometabolic risk factors

et al. 2010

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Background: Obesity is an increasing health problem and surgery seems to be the only treatment effective in achieving weight loss without relapse. Among bariatric techniques, many differences exist in terms of weight loss and resolution of comorbidities. Up to now, there are no prospective studies comparing long-term effects of malabsorptive vs restrictive techniques. Objective: In this study, cardiometabolic risk factors and body composition changes after malabsorptive biliointestinal bypass (BIBP) and restrictive laparoscopic adjustable gastric banding (LAGB) were compared during a 4-year follow-up. Design: Prospective, case-control and cohort study. Patients: In all, 80 obese subjects, matched for weight and age. Altogether, 40 patients underwent BIBP and 40 underwent LAGB. Measurements: Weight, body composition, fasting and post-loading plasma glucose and insulin, homeostatic model assessment index (HOMA-I), lipid profile, blood pressure (BP), erythrocyte sedimentation rate and fibrinogen were monitored at baseline, 12 and 48 months. Results: At 12 months after surgery, a significant reduction in body mass index, total fat mass (FM), trunk FM (trFM), trFM/legs FM (lFM) ratio (trFM/lFM), triglycerides, BP and inflammation markers was observed in both groups. BIBP patients showed a significant reduction in total cholesterol (Tot-C), low-density lipoprotein cholesterol (LDL-C) and high-density lipoprotein cholesterol (HDL-C), whereas the LAGB group showed a significant increase of HDL-C. A further improvement of all the parameters evaluated was seen in the BIBP group at 48 months after surgery. Conclusions: Both bariatric procedures exerted positive effects on cardiometabolic risk factors and on weight loss in the population studied, but on the long-term period, HOMA-I, Tot-C/HDL-C ratio and body composition improvements were more evident after BIBP. We conclude that malabsorptive BIBP seems to be more effective than LAGB in treating visceral obesity and its metabolic complications

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“…Intriguing data exist that bariatric surgery may favorably modify risk factors, induce remission of diabetes mellitus, and reduce death rates. [105][106][107] In other cases, public laws or policies may lead to better outcomes; examples include taxes on sugary beverages, bans on trans fats, smoking bans, and regulated decrements in salt content of processed foods. The impact of these interventions can be examined by quasi-experimental methods.…”

Section: Behavioral Interventions and Complementary Preventive Stratementioning

confidence: 99%

Recent Advances in Preventive Cardiology and Lifestyle Medicine

Franklin

Cushman

2011

Circulation

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M ultifactorial risk factor modification and control, especially interventions designed to reduce total cholesterol, systolic blood pressure, smoking prevalence, overweight/ obesity, diabetes mellitus, and physical inactivity, can have a profound and favorable impact on decreasing the incidence of initial and recurrent cardiovascular events. Between 1980 and 2000, mortality rates from coronary heart disease (CHD) fell by Ͼ40%. Using a previously validated statistical model (IMPACT), researchers attempted to determine how much of this decrease could be explained by the use of medical and surgical treatments as opposed to changes in risk factors among US adults aged 25 to 84 years. Approximately half of the decline in cardiovascular deaths was attributed to reductions in major risk factors (obesity and diabetes mellitus were notable exceptions), and approximately half was attributed to evidence-based medical therapies (eg, secondary prevention medications, rehabilitation, and initial treatments for acute myocardial infarction [AMI]). 1 In contrast, emergent and elective revascularization accounted for only 7% of the overall decline in deaths from CHD. Recently, similar results were reported in a Canadian study that evaluated the decrease in CHD mortality between 1994 and 2005. 2 Over the past decade, mortality rates from CHD and stroke in the United States decreased by Ͼ25% (Figure 1). 3 Although there were also impressive reductions in the prevalence of uncontrolled high blood pressure, elevated blood cholesterol, and, to a lesser extent, cigarette smoking, there was only limited impact on other risk factors, including increases in the prevalence of obesity and diabetes mellitus, and a small reduction in those not engaged in moderate or vigorous physical activity. 3 These indicators represent major challenges to achieving future goals for cardiovascular health promotion and disease reduction.In 2009, a task force representing numerous professional organizations/associations developed a Competence and Training Statement on the Prevention of Cardiovascular Disease. 4 More recently, the American Heart Association (AHA) released its bold new impact goal for the next 10 years, the 2020 Impact Goal: "to improve the cardiovascular health of all Americans by 20% while reducing deaths from cardiovascular diseases and stroke by 20%." 3 This 2020 goal has an innovative new element to improve clinically relevant health and behavioral factors. Cardiovascular health is defined in 3 categories of ideal, intermediate, and poor on the basis of 7 simple health factors and modifiable behaviors, as detailed in the My Life Check assessment tool at http://www.mylifecheck.heart.org.This review provides a compendium of important advances in preventive and lifestyle medicine during the past decade, including discussion of some emerging but unproven interventions (ie, the polypill) as well as the value of conducting large-scale randomized clinical trials rather than relying on biological hypotheses and observational data (ie, the homocy...

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Reduction in Predicted Coronary Heart Disease Risk After Substantial Weight Reduction After Bariatric Surgery

Cited by 97 publications

References 22 publications

Biological effects of bariatric surgery on obesity-related comorbidities

Biological effects of bariatric surgery on obesity-related comorbidities

Metabolic or bariatric surgery? Long-term effects of malabsorptive vs restrictive bariatric techniques on body composition and cardiometabolic risk factors

Recent Advances in Preventive Cardiology and Lifestyle Medicine

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