People with morbid obesity suffer from diabetes, high blood pressure, and many other severe medical conditions that can lead to stroke, heart attack, and death when left untreated. Doctors typically recommend a healthy diet and exercise to help individuals lose weight. However, a more direct and efficient form of weight loss, such as bariatric surgery (e.g., gastric sleeve or bypass), may improve patients’ overall health.
The primary goal of bariatric surgery is to reduce excess weight, yet these surgical procedures can also lessen the risk of other co-morbidities or co-occurring disorders. Research studies have shown that weight loss surgery dramatically cuts the risk of heart disease, stroke, and death.
We will cover how these weight loss procedures reverse hypertension, improve metabolic function, and significantly lower the risk of life-threatening events like heart failure and stroke.
How Does Obesity Affect the Cardiovascular System?
Obesity is one of the most significant contributors to cardiovascular system problems. It’s important to understand that obesity is determined by body mass index (BMI), which considers two parameters – height and weight.
Excess fat contributes to high cholesterol, high blood pressure, and type 2 diabetes. It can also lead to fatty buildup in your blood vessels, which can cause them to become damaged and clogged. These factors all add up to circulatory disease.
The Department of Health and Human Resources discovered a direct link between BMI and mortality (death) among adults who had never smoked.[1] Mortality directly correlated to cardiovascular disease (primarily stroke and heart disease) was the #1 cause of death.[2]
The major cardiovascular issues related to obesity include:
- Heart disease
- Stroke
- Risk of heart attack
- Congestive heart failure
- Coronary heart disease
How Weight Loss Surgery Reduces Strain on the Heart
Bariatric and metabolic surgery lowers the risk factor of Major Adverse Cardiovascular Events (MACE) by almost 40%. Additionally, premature deaths among the bariatric group decreased by almost half.[3] Bariatric surgery reduces systemic inflammation (measured by C-reactive protein) and improves “ventricular remodeling” (the heart’s shape and efficiency).
The most popular obesity-treating weight loss surgeries include;
- Laparoscopic sleeve gastrectomy (gastric sleeve surgery)
- Laparoscopic Roux-en-Y (gastric bypass surgery)
- Adjustable gastric banding (LAP-BAND)
The correlation between bariatric surgery and a reduction in heart attack risk has to do with how obesity, hypertension, diabetes, and hyperlipidemia can significantly increase the likelihood of coronary artery disease. Therefore, one of the most important things to reduce this risk is to lose weight.
Jump to Effects of Bariatric Surgery on CVD Risk Factors, Myocardial … – Bariatric surgery induces prompt weight loss within a few months which lasts for at least 12–18 months, with mean weight loss of ~35% (~70% loss of excess weight), lowering the risk of all-cause mortality, myocardial infarction, and stroke.
When Does Bariatric Surgery Become an Option for Treating Circulatory Disease?
Metabolic and bariatric surgery is fast becoming one of the best options for weight loss since it allows super obese patients to shed rapidly and efficiently as much as 50% of their excess body weight in the first year alone. The rapid weight loss achieved by most bariatric surgery procedures, like gastric sleeves, does play a role in the reduction of heart attack risk.
Another important consideration to make is that to qualify for weight loss surgery, patients need to make a commitment to proper diet and exercise, and so the patients who underwent the surgery are almost guaranteed to have committed more deeply to losing weight and getting healthy than those who did not undergo the surgery.
Researchers are still working to determine just how much of a risk reduction can be expected. However, high-sensitivity C-Reactive Protein (hs-CRP), a predictor of cardiovascular risk, is reduced considerably in patients who undergo gastric stapling operations.
Research Studies & Breakthroughs: Bariatric Surgery and Heart Health
Recent studies have focused on seriously obese patients at high risk for heart disease and how bariatric surgery has significantly reduced this threat. Research worldwide has discovered a significant improvement in cardiovascular-related death rates in obese patients after weight loss operations like vertical sleeve gastrectomy, gastric banding, and even RNY gastric bypass. Here we are noting four of these studies:
1. Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity (2022-2024)
A study published in JAMA with 13,000 patients, done by Dr. Steven Nissen and the Cleveland Clinic, showed:
- 39% Lower Risk: Patients who underwent surgery were 39% less likely to experience a “major adverse cardiovascular event” (heart attack, stroke, or heart failure).
- 41% Lower Risk of Death: The surgical group had a 41% lower risk of death from any cause compared to those receiving standard medical care.
- Significant Diabetic Improvement: The study found that the metabolic changes from surgery were “unparalleled” by medication alone at the time.
2. Effects of Bariatric Surgery on Cardiovascular Disease – Journal of the American Medical Association (2019)
In 2019, a study by the Journal of the American Medical Association followed 4,000 obese Swedish people who had undergone bariatric surgery. Between 1987 and 2001, the study found a decreased number of cardiovascular deaths and a lower incidence of cardiovascular events in obese adults.
This study isn’t alarming, as there have been numerous reports highlighting the various health and psychological benefits of extreme weight loss. Currently, type 2 diabetes, high cholesterol, hypertension, and other diseases are said to be substantially minimized after bariatric surgery.
Results of Study: Decreased Cardiovascular Issues
The study found that obese people who decided not to undergo weight loss surgery suffered more cardiovascular issues, including death. In Sweden, 2,000 individuals who underwent the obesity treatment and 2,000 individuals who opted against it were followed. This 14.7-year (average) study found that 199 who underwent bariatric surgery had their first heart attack or stroke, with 28 deaths. Of the group who did not opt for the operation, 234 people had their first heart attack or stroke, with 49 deaths.
When the researchers took into account the initial health differences between people who did and did not get surgery, they found that after the surgery, patients were about 30 percent less likely to have a first-time heart attack or stroke than non-surgery patients, and half as likely to die from one.
CBS News Story: Study finds weight loss surgery decreases risk of heart attack and stroke
3. Bariatric Surgery and Its Impact on Cardiovascular Disease and Mortality – International Journal of Cardiology (2014)
A study published on March 28, 2014, in the International Journal of Cardiology examined weight-loss surgery and its impact on a person’s risk of heart attack. This study, conducted in the United Kingdom, was the first comprehensive examination of weight-loss surgery and its significant impact on heart disease and stroke.
The International Journal of Cardiology looked at the outcomes for people at high risk of heart attack, including both those who had undergone bariatric surgery and those who had not. What the research showed was that the operation had potentially life-saving benefits, capable of lowering the risk of heart attack and stroke in obese patients by as much as 50 percent. This is according to Dr. Yoon Loke, the study’s senior author from Norwich Medical School at the University of East Anglia in England.
They had breakthrough results and found a nearly 40% reduction in death rates among patients who had surgery compared to those who didn’t.
UK Research on 14 Previous Studies
Researchers began by reviewing 14 previous studies involving more than 29,000 patients who had undergone weight-loss surgery. The mean age of patients in these studies was 48, and 30% of the patients were men. These participants were followed for between 2 and 14 years. Of the patients who had experienced bariatric surgery, such as the gastric sleeve procedure, there was a 40% reduction in death rates as compared to patients who had not had the procedure. This is according to the study findings that were published in the International Journal of Cardiology on March 28.
4. Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects – New England Journal of Medicine (2007)
A group of Swedish researchers, publishing in the New England Journal of Medicine, recently followed 4,047 men and women with abnormally high body mass for an average of 15 years. Of these individuals, roughly half decided to undergo bariatric surgery at the beginning of this study. Of the approximately 50 percent of people who opted to have surgical intervention, research showed that they were 33 percent less likely to experience a heart attack or a stroke as compared to the other half of participants who did not undergo the procedure. These individuals were also around 53 percent less likely to experience death resulting from a heart attack or stroke.
Researchers found that the reduction in heart attack risk was similar among patients who lost substantial weight and those who lost only small amounts, even though both groups underwent similar weight-loss surgery. According to Lars Sjöström, M.D., Ph.D., a professor of internal medicine, the benefit was the same regardless of the amount of weight lost across all patients who underwent bariatric procedures at successful medical centers.
More Information is Necessary
The benefits of bariatric surgery are a topic that researchers are still working to fully understand. Because success rates can vary from patient to patient depending on their commitment to lifestyle changes, the reduction in the risk of death or serious illness can vary significantly as well. The authors of the study mentioned above have acknowledged that deeper research and a larger study are going to be required to understand the scope of bariatric surgery benefits and how these types of surgical procedures can reduce the risk of heart attack, stroke, and other dangerous and deadly conditions.
Next Steps for Heart Patients
We understand that patients with existing heart conditions have unique concerns. To ensure your safety and provide peace of mind, our comprehensive cardiac protocol includes:
- Pre-Op Cardiac Clearance: The surgical teams at Mexico Bariatric Center may require cardiac clearance as part of the approval process to ensure safety.
- Cardio Anesthesiologist: Specialized, high-risk care before, during, and after heart surgeries, improving patient safety through tailored anesthesia.
Don’t Wait for a Cardiac Event to Take Action
Heart disease is the leading cause of death in the entire world. As it increases the risk of heart attack and stroke, heart disease makes up over 23% of all deaths globally. This means that 1 out of every 4 people dies due to major cardiovascular problems, typically related to being overweight or obese.[4]
Bariatric surgery is now proving to reverse major heart problems related to obesity. Due to the significant amount of weight loss afforded to patients through bariatric surgery, it is now becoming apparent that these surgeries are significantly lowering these fatal heart problems.
Researchers are working to better understand the correlation between bariatric surgery and heart attack risk reduction so that patients who are at serious risk of heart attack can begin to take steps to reduce that risk.
Although bariatric surgery is known to help reduce heart problems in the long run, it does impose short-term stress on the heart immediately following the operation. According to Harvard Health Publications, heart attacks and cardiac problems cause about one in five post-operative deaths. This is a reflection of the damage caused by being obese for years, and it’s the effect on the heart and blood vessels.
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