Severely obese patients who undergo bariatric surgery have a significantly reduced risk of developing coronary heart disease (CHD), according to a new study. The findings were presented November 14 at ObesityWeek 2018, hosted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and The Obesity Society (TOS) in Nashville, Tennessee.

"This is another example of the growing body of literature underlying the effectiveness of metabolic surgery on the many co-morbid conditions associated with obesity," study co-author Dr. Emanuele Lo Menzo from the Cleveland Clinic Florida in Weston told Reuters Health by email. He added that bariatric surgery "has the ability to lower the risk of developing CHD by 40% in both women and men."

Effect of bariatric surgery

The researchers took a look back at 225 obese patients (mean age 51, 67% women) with no previous diagnosis of CHD who underwent bariatric surgery from 2010 to 2016 (65% laparoscopic sleeve gastrectomy, 27% gastric bypass, 2% other).

Twelve months after bariatric surgery, patients' total weight had dropped by 27% and BMI by 69%. Diabetes and hypertension resolved in about 40% of patients. Improvements in LDL and HDL cholesterol were also noted.

Before surgery, patients had a 10-year risk of developing CHD based on the Framingham Risk Score that was more than eight-fold higher than ideal (8.87 vs. 1.3). One year after surgery, women had a 42% relative risk reduction in the Framingham risk score (6.45 to 3.74) and men had a 39% relative risk reduction (13.91 to 8.51).

"Several studies in the literature have shown the positive metabolic effects of bariatric surgery. However, only a few studies have addressed the specific benefits of bariatric surgery for CHD. To our knowledge this is the only one that specifically addresses the above-mentioned benefits using a validated CHD risk score for both gastric bypass and gastric sleeve," Dr. Lo Menzo told Reuters Health.

"Our study shows bariatric surgery has a significant and unparalleled effect on the known risk factors for coronary heart disease in patients after one year," he added in a news release.

"The risk of coronary heart disease in people with severe obesity is profound and the effect of bariatric surgery on that risk is equally profound. This study provides further proof that treating obesity means treating heart disease and a whole host of other diseases," Dr. Eric DeMaria, president of the ASMBS and professor and chief, division of general/bariatric surgery at Brody School of Medicine at East Carolina University in Greenville, North Carolina, who was not involved in the study, said in the release.

Current guidelines for adults state that bariatric surgery may provide significant health benefits for patients with a BMI of 40 or higher or a BMI of 35 or higher who have two other cardiovascular risk factors.