Women have lower heart disease risk than men after bariatric surgery
Sunday - November 6, 2016 12:12 am
Women have about a 20% less chance of developing heart disease after weight-loss surgery than men, according to new research presented at Obesity Week 2016,
The annual conference is hosted by the American Society for Metabolic and Bariatric Surgery (ASMBS) and The Obesity Society (TOS).
According to researchers from Stanford University School of Medicine, while both genders significantly reduce their risk of developing cardiovascular disease over a 10-year period, women seem to benefit more.
One year after surgery, women reduced their risk by 41%, while men reduced their risk of heart disease by 35.6%.
The study followed 1,989 patients who underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy at the Stanford BMI Clinic.
Biochemical cardiac risk factors (BCRFs) were collected preoperatively and 12 months after surgery.
The Framingham Coronary Heart Disease Risk Score was used to estimate the risk of a heart attack in 10 years before surgery and at the one-year mark.
At one year, women had greater improvement than men for the Framingham Coronary Heart Disease Risk Score — 44.7% vs. 41.4%.
In addition, women who had bariatric surgery had an absolute lower relative risk than men at one year with a one-year risk score of 5.11 vs 11.2 respectively.
Furthermore, women had less abnormal HDL or good cholesterol levels than men at one year — 10.1 vs 21.8, respectively.
Finally, excess weight loss was greater for women — Men: 65.9% ± 21.1%, Women: 73.3% ± 23.8%.
“Obesity is a major and modifiable risk factor for heart disease, the leading cause of death in the United States for both men and women,” said a researcher.
“This study suggests, however, that men and women may respond differently to bariatric surgery when it comes to heart health despite comparable weight loss.”
Notable reductions in the 10-year risk of developing cardiovascular disease for both genders post-surgery were noted with women demonstrating significantly lower risk compared to men pre- and post-surgery.
Men were able to normalize levels of HbA1c and triglycerides and waist circumferences better than women post-surgery. Men may be more metabolically receptive to bariatric surgery.
Women were able to normalize levels of CRP better, maintain higher HDL levels, and had a higher% of excess weight loss following surgery compared to men.
Each gender showed significant cardiac risk improvement in response to bariatric surgery, however that may be through gender-distinct mechanisms.
Metabolic/bariatric surgery has been shown to be the most effective and long lasting treatment for morbid obesity and many related conditions and results in significant weight loss.
The Agency for Healthcare Research and Quality (AHRQ) reported significant improvements in the safety of metabolic/bariatric surgery due in large part to improved laparoscopic techniques.
The risk of death is about 0.1% and the overall likelihood of major complications is about 4%.
According to the Centers for Disease Control and Prevention (CDC), in 2011–2014, the prevalence of obesity was just over 36% in adults, with a higher prevalence among women than men (38.3% vs. 34.3%) and older than younger adults (37% vs. 32.3%).
Obese is medically defined as having a body mass index (BMI), a measure of height to weight, that’s more than 30. The ASMBS estimates about 24 million Americans have severe obesity, which would mean a BMI of 35 or more with an obesity-related condition like diabetes or a BMI of 40.