Reduction in Cardiovascular Risk After Bariatric Surgery

Reduction in Cardiovascular Risk After Bariatric Surgery

Obesity is now significantly increasing in even developing countries like India. Due to its presence in all countries. Obesity is most commonly measured in terms of Body Mass Index (BMI), which is your weight in kilograms divided by your height in meter square.

Obesity, along with it, brings myriad problems, most importantly hypertension, diabetes mellitus, hypercholesterolemia, sleep apnoea, increased cardiovascular risk, polycystic ovarian disease, multiple joint pains, fatty liver disease, cancers, gastroesophageal reflux, and many more.

Epidemiological studies have shown that obesity is a significant risk factor for major cardiovascular problems like coronary artery disease, arrhythmias, heart failure, and sudden cardiac death. Cardiovascular morbidity and mortality can be triggered with accretions of sleep-disordered breathing, inflammation, left ventricular hypertrophy, left arterial enlargement, and subclinical left ventricular systolic and diastolic dysfunction.

Bariatric surgery or weight loss surgery has a very positive impact on cardiovascular health in obese patients. Bariatric surgery can be performed in the Asian population whose BMI is more than 33 with comorbidities like hypertension, diabetes, sleep apnoea, PCOD, etc., or whose BMI is more than 37 with no comorbidities. Bariatric surgery helps to reduce 80-85 % of your excess body weight.

After bariatric surgery, any of the above cardiovascular risk factors better or disappear. Since the surgically induced weight loss, cardiac structure and function have consistently improved. The amount of improvement in cardiac risk factors is generally proportional to the amount of weight lost. Progression of atherosclerosis could be slowed, and the 10-year risk of cardiac events would decline by ~ 50% in patients undergoing weight loss surgery. Bariatric surgery generally is associated with a significant lowering of systolic blood pressure.

Following bariatric surgery, there are reductions in several components of serum lipids. The magnitude of favorable changes in triglycerides and HDL are typically larger than what can be achieved with the currently available pharmacological treatment of dyslipidemia. Obesity, particularly visceral obesity, is believed to be an inflammatory state. Systematic inflation is thought to play a role in multifaceted cardiovascular risk, which entails the succession of atherosclerosis and the formation of dysfunctional atherosclerotic plaques. After bariatric surgery, essentially all inflammatory markers show significant decreases.

Finally, a large body of evidence suggests that the adverse cardiovascular risk profile seen in obese people improves dramatically 2-10 years after weight loss surgery. In the same way, cardiac geometry and structure have improved. The significant improvements in cardiac risk factors appear to translate into a slowed progression of atherosclerosis and a significant reduction in total and cardiovascular mortality over 10-years. Given the unequivocal sustained benefits of surgically induced weight loss, it is likely that bariatric surgery will continue to evolve and have an expanding role in preventing cardiovascular disease.

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