The primary goal of bariatric surgery is to reduce excess weight, and by doing this, these types of operations can also lessen the risk of other co-morbidities or co-occurring disorders.
Frequently people who are morbidly obese suffer from hypertension, diabetes, high blood pressure, and a multitude of other serious medical conditions which can lead to stroke, heart attack, and death when left untreated.
How Does Obesity Affect the Cardiovascular System
Obesity is one of the biggest contributing factors to having severe cardiovascular system problems. It’s important to understand that obesity is defined by body mass index (BMI). This takes into account two factors – height and weight.
The Department of Health and Human Resources discovered a direct link between BMI and mortality (death) among adults who had never smoked. In 2008, mortality directly correlated to cardiovascular disease (primarily stroke and heart disease) was the #1 cause of death.
The major cardiovascular issues related to obesity include:
- Heart disease
- Risk of heart attack
- Congestive heart failure
- Coronary heart disease in patients who were previously at risk of severe heart conditions.
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.
We will cover how weight loss surgery relieves stress on morbidly obese patients who are living with the constant anxiety that they may suffer heart failure or stroke because of their low physical activity, sluggish metabolism, and the extra strain on their heart caused by carrying extra weight.
The Link Between Bariatric Surgery and Heart Disease
Bariatric and metabolic surgery lower the risk factor of Major Adverse Cardiovascular Events (MACE) by almost 40%. Additionally, premature deaths among the bariatric group were decreased by almost half.
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 garner weight loss.
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 Heart Disease
Metabolic and bariatric surgery is fast becoming one of the best options for weight loss since it allows for morbidly 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 sleeve, 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 and Breakthroughs: Bariatric Surgery and Heart Disease
Recent studies have focused on seriously obese patients who are at high risk for heart disease, and how this risk has been significantly reduced through the use of bariatric surgery. Research from around the world discovered a significant improvement in the reduction of cardiovascular-related death rates in obese patients after weight loss operations like vertical sleeve gastrectomy, gastric banding, and even RNY gastric bypass was performed.
Effects of Bariatric Surgery on Cardiovascular Disease (2019) – Journal of the American Medical Association
In 2019, a study by the Journal of the American Medical Association followed 4,000 obese Swedish people who’ve 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 were found to suffer 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. 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.
Fox News Story: Fewer Heart Attacks After Weight Loss Surgery
Bariatric Surgery and its Impact on Cardiovascular Disease and Mortality – International Journal of Cardiology (2014)
According to a study published on March 28, 2014, by the International Journal of Cardiology, looked into weight loss surgery and its impact on a person’s risk of a heart attack. This study, which was held in the United Kingdom, was the first real comprehensive look at weight loss surgery and its critical 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 that didn’t.
UK Research on 14 Previous Studies
Researchers began by looking at 14 different previous studies that involved a sum of more than 29,000 different patients having had 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 two and 14 years. Of the patients who had experienced bariatric surgery, such as the gastric sleeve procedure, there was a 40 percent 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.
Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects – New England Journal of Medicine (2007)
A group of Swedish researchers of the New England Journal of Medicine recently followed 4,047 men and women who were considered morbidly obese for 15 years on average. Of these individuals, roughly half of all participants decided to have bariatric surgery at the beginning of this study. Of the approximately 50 percent of people who opted to have a 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.
One thing that researchers noticed was that the heart attack risk reduction was similar among patients who lost very large sums of weight and those who only lost small amounts of weight, even though both types of patients underwent similar types of weight reduction surgery. According to Lars Sjöström, M.D., Ph.D., who is a professor of internal medicine, the benefit was the same regardless of how much weight was lost, among all the patients who underwent bariatric procedures at successful medical centers.
More Information is Necessary
The benefit of bariatric surgery is a topic that researchers are still working to understand fully. Because the success rates can vary from patient to patient depending on their commitment to lifestyle changes, the reduction in risk of death or serious illness can also vary rather significantly as well. The authors of the study mentioned above have acknowledged that deeper research and a larger study is 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.
The Bottom Line
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 die due to major cardiovascular problems, typically related to being overweight or obese.
Researchers are working to understand better 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 chance.
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 create about one in five post-operative deaths. This is a reflection of damages caused by being obese for years and it’s the effect on heart and blood vessels.