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ObesityWeek 16

Women have lower risk of heart disease post-surgery

One year after surgery, women reduced their risk by 41 percent, while men reduced their risk of heart disease by 35.6 percent.

Women have about a 20 percent less chance of developing heart disease after weight-loss surgery than men, according to research presented at ObesityWeek 2016. 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 percent, while men reduced their risk of heart disease by 35.6 percent.

“This study shows there is a gender disparity in cardiac outcomes for patients undergoing bariatric surgery,” said lead study author, Dr John M Morton, Director of Bariatric Surgery at Stanford Hospital & Clinics and immediate past-president, ASMBS. “The findings suggest that women may have an enhanced mechanism of response to bariatric surgery, which leads to greater normalisation of biochemical cardiac risk factors.”

The study, “Are There Gender Disparities in Cardiac Outcomes Following Bariatric Surgery?” assessed 1,989 patients who underwent laparoscopic Roux-en-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) at the Stanford BMI. Subjects were divided into two cohorts based on gender. Biochemical cardiac risk factors (BCRFs), including hemoglobin A1c, total cholesterol, HDL, LDL, triglycerides, C-reactive protein (CRP), lipoprotein(a), homocysteine, and BNP, were collected preoperatively and at 12 months following surgery. Framingham Risk Scores for developing cardiovascular disease within ten years were also calculated at these time points.

At one year, women had greater improvement than men for the Framingham Coronary Heart Disease Risk Score - 44.7 percent vs. 41.4 percent. 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. In addition, 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%.

The authors concluded that this study finds “notable improvements in reductions in 10-year risk of developing cardiovascular disease for both genders undergoing bariatric surgery, with women demonstrating significantly lower Framingham Risk Scores compared to men post-surgery. It also demonstrates significant differences between men and women for measured BCRFs pre- and post- operatively. Notably, women had significantly higher CRP levels than men pre-operatively, but these differences were no longer significant one year after surgery. Furthermore, HDL levels were significantly more abnormal in men compared to women even one year after surgery. These results suggest that women may have an enhanced mechanism of response to bariatric surgery, which leads to greater normalisation of BCRFs and potential lower risk of developing heart disease, as compared to men.”

“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 Dr Stacy Brethauer, a bariatric surgeon at the Cleveland Clinic and ASMBS President-Elect, who was not involved in the study. “This study suggests, however, that men and women may respond differently to bariatric surgery when it comes to heart health despite comparable weight loss.”

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