Weight Loss Surgery Can Reduce Mortality, Heart Failure

Abd Tahrani, MD

A new study from investigators in the United Kingdom is revealing more about the cardiovascular benefits of bariatric surgery.

According to the study, patients who underwent bariatric surgery had a 30% lower risk of all-cause mortality, a 43% lower risk of developing heart failure, and a 59% lower risk of developing hypertension when compared to obese patients who did not undergo weight loss surgery.

"Obesity is a chronic disease that is associated with many comorbidities and complications. Our results show the benefits of weight loss surgery in reducing the health burdens of obesity in real-world data," said lead investigator Abd Tahrani, MD, of Queen Elizabeth Hospital, in the United Kingdom, in a press release.

In response to an apparent lack of real-world data surrounding the topic, investigators sought to determine to what degree bariatric surgery could reduce all-cause mortality and mortality from cardiovascular disease in obese adults. To do so, investigators conducted a retrospective, matched, controlled cohort study using data from the Health Improvement Network primary care database, which lasted from 1990 through January 2018 and represented 6% of the population in the United Kingdom.

In the current analysis, conditions and outcomes of interest were incident cardiovascular disease, hypertension, atrial fibrillation, and all-cause mortality. A total of 15,165 participants were included by investigators—of which 5170 were included in the intervention group and 9995 were included as controls. All patients included in the intervention group had a BMI of 30 kg/m2 or greater and no history of gastric cancer.

The mean age of study participants was 45.3 (10) years and 21.5% of participants had type 2 diabetes mellitus. Investigators noted the follow-up period lasted a median of 3.9 years and, during that period, the mean percentage of weight loss was 20% in the intervention group and 0.8% in the control group.

Upon analyses, bariatric surgery was not associated with a significantly lower risk of cardiovascular disease (aHR 0.80; 95% CI, 0.62 to 1.02; P=.074), but patients who received gastric bypass saw a significant impact on cardiovascular disease as a result (HR 0.53; 0.34 to 0.81; P=.003). Results indicated bariatric surgery was associated with a significant reduction in all-cause mortality (aHR 0.70; 0.55 to 0.89; P=.004), hypertension (aHR 0.41; 0.34 to 0.50; P<.001), and heart failure.

When comparing results for those with type 2 diabetes mellitus, investigators pointed out results indicated outcomes were similar among both groups, with the exception of atrial fibrillation which was reduced among patients with type 2 diabetes mellitus.

This study, titled “Impact of bariatric surgery on cardiovascular outcomes and mortality: a population&#8208;based cohort study,” was published online in the British Journal of Surgery.