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Bariatric Tx Rejuvenates Heart, Cuts CV Risk

— Ethnicity a factor in degree of cardiovascular benefit but not for weight loss

MedpageToday

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BALTIMORE -- For select ethnic groups, bariatric surgery significantly reduced cardiovascular risk and heart age, although ethnicity did not affect weight loss following bariatric surgery, according to researchers here.

In the retrospective, cohort study, patients' mean heart age preoperatively versus at 12 months post-op was:

  • African Americans: 71.3 vs 65.9 (P=0.11)
  • Caucasians: 71.3 vs 62.4 (P<0.0001)
  • Multicultural: 54.3 vs 43.4 (P=0.01)

Patients' mean cardiovascular risk score preoperatively versus postoperatively by ethnicity was 21% vs 16% (P=0.23) for African Americans, 24% vs 15% (P<0.0001) for Caucasians, and 6% vs 2% (P=0.03) for multicultural patients, reported Cristian Milla, MD, of the Cleveland Clinic in Weston, Florida, and colleagues at the Society of American Gastrointestinal and Endoscopic Surgeons meeting.

Mean BMI preoperatively versus postoperatively by ethnicity was 41.7 versus 32.0 for African Americans, 41.4 versus 30.8 Caucasians, and 38.6 versus 27.6 for multicultural, Milla added.

Heart disease "is the principal cause of death among all ethnic groups. Some well known risk factors for heart disease include high blood pressure, tobacco smoking, high cholesterol, obesity, as well as diabetes," Milla said. Prior data looking at "the most common cardiovascular diseases by ethnic group ... found a higher prevalence of the most common among the African-American population like coronary artery disease, acute myocardial infarction, and hypertension death rates."

"And when analyzing the total cardiovascular disease rate among all ethnic groups, same findings, [there is] higher prevalence among African Americans," he stated.

In addition, the "prevalence of obesity is increasing in both adult populations and youth. And when analyzing the prevalence of obesity among ethnic groups, we found a higher prevalence of obesity among Hispanics and African Americans," Milla stated.

The authors evaluated 43 African-American, 249 Caucasian, and seven multicultural patients who underwent bariatric surgery. The mean age was 52.6 and 67.5% were female.

With a retrospective chart review, they assessed patients from all ethnicities and evaluated comorbidities, demographics, cardiovascular risk score, and heart age at the time of the operation, and at 12 months follow-up.

The researchers used the ASCVD Risk Calculator as determined by the 2013 ACC/AHA Guideline to calculate the cardiovascular risk score, and used the Framingham Study Heart Age Calculator to calculate the heart age.

They did find a significant reduction in diabetes preoperatively for Caucasian patients (P<0.0001), but not in African-American (P=0.19) or multicultural patients.

Study limitations included loss of follow-up, the small cohort sample, and the retrospective design.

Disclosures

Milla disclosed no relevant relationships with industry.

Primary Source

Society of American Gastrointestinal and Endoscopic Surgeons

Bellini A, et al "The impact of ethnicity on cardiovascular risk reduction and heart age after bariatric surgery" SAGES 2019.