Bariatric surgery cuts heart disease risk for people with obesity

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Bariatric surgery decreases the risk of heart disease, new research suggests.

The study of adults with nonalcoholic fatty liver disease (NAFLD) and morbid obesity (body mass index > 40) shows that those who underwent bariatric surgery suffered far fewer extreme cardiovascular events subsequently.

The researchers report that patients with obesity undergoing bariatric surgery were nearly 50% less likely to develop adverse cardiovascular events such as heart attacks, angina, or strokes.

“The findings provide evidence in support of bariatric surgery as an effective therapeutic tool to lower elevated risk of cardiovascular disease for select individuals with obesity and NAFLD,” says Vinod K. Rustgi, professor of medicine, clinical director of hepatology, and director of the Center for Liver Diseases and Liver Masses at Rutgers Robert Wood Johnson Medical School. “These finding are tremendously impactful for many reasons.”

Heart disease is the leading cause of death for men and women across the board for racial and ethnic groups in the United States. About 697,000 people in the country died from heart disease in 2020, according to the US Centers for Disease Control and Prevention.

NAFLD, and a more advanced form known as NASH, are rapidly increasing causes of liver disease, and can affect people who drink little to no alcohol. The condition, which occurs because too much fat is being stored in liver cells, inciting an inflammatory state, is more common in people with obesity and type 2 diabetes.

For the study, published in JAMA Network Open, the researchers analyzed outcomes data, using the MarketScan Commercial Claims and Encounters medical insurance database, from 2007 to 2017.

Of 230 million covered individuals, 86,964 adults between the ages of 18 and 64 who had obesity and NAFLD were identified. Of those, 68% of the study group were female, 35% underwent bariatric surgery, and 65% received nonsurgical care.

Bariatric surgery patients experienced a 49% decrease in the risk of developing major cardiovascular events such as heart attacks, heart failure, or ischemic strokes. They were also far less likely to experience angina, atherosclerotic events, or arterial blood clots.

The association between bariatric surgery and risk reduction of developing cardiovascular disease has not been studied to this level of detail before, the researchers say.

There is growing evidence that bariatric surgery, because of the weight reduction it brings about in patients, offers definitive health benefits.

An earlier study conducted by Rustgi and colleagues, published in the journal Gastroenterology last year, showed that bariatric surgery can also significantly reduce the risk of cancer—especially obesity-related cancers—in obese individuals with NAFLD. Importantly, these cancers include colorectal, pancreatic, endometrial, thyroid cancer, multiple myeloma, and hepatocellular carcinoma.

“Although bariatric surgery is a more aggressive approach than lifestyle modifications, it may be associated with other benefits, such as improved quality of life and decreased long-term health care burden,” Rustgi says.

Additional coauthors are from Ohio State University and Rutgers.

Source: Rutgers University