Bariatric Surgery and Cardiovascular Risk Factors: A Scientific Statement From the American Heart Association
Abstract
MetabolismT he rate of obesity is rising logarithmically, especially in those with severe obesity (body mass index [BMI] Ͼ40 kg/m 2 ).Cardiologists, endocrinologists, internists, family practitioners, and most healthcare professionals are increasingly confronted with the severely obese patient and with postoperative bariatric patients because obesity is associated with significant morbidity and increased mortality.In addition, more adolescents these days are severely obese.Substantial long-term successes of lifestyle modifications and drug therapy have been disappointing in this population.The National Institutes of Health has suggested that surgical therapy be proposed to those patients with BMI Ͼ40 kg/m 2 or Ͼ35 kg/m 2 with serious obesity-related comorbidities such as systemic hypertension, type 2 diabetes mellitus, and obstructive sleep apnea.When indicated, surgical intervention leads to significant improvements in decreasing excess weight and comorbidities that can be maintained over time.These include diabetes mellitus, dyslipidemia, liver disease, systemic hypertension, obstructive sleep apnea, and cardiovascular dysfunction.Recent prospective, nonrandomized, observational, or case-control population studies have also shown bariatric surgery to prolong survival in the severely obese.Different types of bariatric procedures are being performed.Historically, operative mortality was between 0.1% and 2.0% with more recent data not exceeding 1%.Early complications include pulmonary embolus (0.5%), anastomotic leaks (1.0% to 2.5%), and bleeding (1.0%).Late complications include anastomotic stricture, anasto-motic ulcers, hernias, band slippage, and behavioral maladaptation.The number of bariatric operations being performed is increasing tremendously as a result of increasing medical need and the evolution of safer surgical techniques and guidelines.Currently, bariatric surgery should be reserved for patients who have severe obesity in whom efforts at medical therapy have failed and an acceptable operative risk is present.
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Orlistat and/or bariatric surgery are the only options for patients with BMI ≥40 kg/m2 or BMI ≥35 kg/m2 with high-risk comorbid conditions.
“Medical therapy with orlistat 388 and/or bariatric surgery 389 for patients with a BMI ≥40 kg/m 2 or a BMI ≥35 kg/m 2 in the presence of high-risk comorbid conditions are the only options.”
From European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) (2012) · cites this paper as [389]
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European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)
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Cardiovascular effects of bariatric surgery
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Metabolic adaptations after bariatric surgery: Adipokines, myokines and hepatokines
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- Authors
- Poirier, P., Cornier, M.-A., Mazzone, T., Stiles, S., Cummings, S., Klein, S., McCullough, P. A., Ren Fielding, C., & Franklin, B. A.
- Venue
- Circulation
- Published
- 2011-04-19
- Volume
- 123
- Issue
- 15
- Pages
- 1683-1701
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2087780912
- Cited by
- 339
- References
- 215
- Citations by year
- 2026: 8 · 2025: 15 · 2024: 14 · 2023: 16 · 2022: 16 · 2021: 22 · 2020: 21 · 2019: 24 · 2018: 19 · 2017: 19 · 2016: 27 · 2015: 31 · 2014: 27 · 2013: 24 · 2012: 39
- FWCI
- 34.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Circulation (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Surgery › Body Contouring and Surgery
- Keywords
- bariatric surgery, morbid obesity, cardiovascular risk factors, obesity-related comorbidities, type 2 diabetes, systemic hypertension, obstructive sleep apnea, dyslipidemia, postoperative complications, postoperative mortality, surgical indications, adolescent obesity
- MeSH terms
- American Heart Association, Cardiovascular Diseases, Humans, Obesity, Postoperative Complications, Risk Factors, United States, Bariatric Surgery
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