Heart disease and bariatric surgery

When patients seek bariatric surgical care, often this is prompted by medical conditions that have developed as they experienced an increase in body weight and BMI (their medical comorbidities). Although patients may be familiar with many of these medical issues, one set of issues is often overlooked but is related to heart disease. Many published studies have demonstrated that cardiovascular ailments associated with obesity include early and accelerated coronary atherosclerosis (hardening of the heart arteries), myocardial infarction (heart attack), congestive heart failure, stroke, abnormal heart rhythms (including atrial fibrillation) and sudden cardiac death.

Conventional cardiac risk factors that are commonly associated with obesity include hypertension, diabetes, and dyslipidemia (particularly low HDL and high triglycerides). In addition, insulin resistance, sleep disordered breathing (such as obstructive sleep apnea) and systemic inflammation are all potential contributors to the cardiovascular risk profile in obesity. Coronary artery calcification (CAC) is a highly specific marker of coronary atherosclerosis. Obese subjects are more likely to have CAC than non-obese subjects. In addition to coronary atherosclerosis, obesity is associated with adverse structural changes in the heart including left ventricular (LV) hypertrophy.

The unfortunate consequence of all of these vascular and heart-related medical conditions is that they may lead to early and unexpected death.

There is good news, however!

Numerous published studies (and our experience at Prisma Health Bariatric Solutions) have demonstrated that bariatric surgery leads to improvement in most problems related to heart disease including high blood pressure, elevated cholesterol, lipid problems, heart enlargement (dilated heart, or abnormal thickening of the heart muscle), and vascular (artery and vein) and coronary (heart artery) disease!

Abundant scientific evidence shows that the adverse cardiovascular risk profile seen in obese subjects is profoundly improved 2–10 years after weight-loss surgery. Similarly, there are improvements in cardiac geometry and structure. The significant improvements in cardiac risk factors appear to translate into slower progression of “hardening of the arteries” and a significant reduction in the chance of dying from a heart-related condition following surgical weight loss.

It is critical to remember that weight loss—whether achieved by lifestyle modification, pharmacotherapy or bariatric surgery—is associated with favorable changes in cardiovascular risk factors. In general, the magnitude of improvement in cardiovascular risk factors is proportional to the amount of weight loss, regardless of the mechanism of weight loss (diet vs. surgical). Surgical patients will often lose more weight than patients who try diets, exercise or a combination of both. In fact, patients who chose to pursue weight loss surgery often have failed at a number of attempts to lose weight in the past.

If you, a loved one or a friend is interested in learning more about bariatric surgery, please feel free to attend an online information session via our website. For those who prefer to speak with someone in person, please call our office at (864) 676-1072 for more information. Remember, bariatric surgery isn’t only about the weight you lose; it’s about the life you gain!

 

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