Bariatric surgery improves heart health, survival in obese patients with obstructive sleep apnea
Bariatric surgery is associated with significant improvements in the long-term heart and cardiovascular health of obese patients with moderate or severe obstructive sleep apnea (OSA), according to new data published in the Journal of the American College of Cardiology.[1] It also helps patients live longer.
“Currently, metabolic surgery is the most effective treatment for obesity and improves cardiovascular risk factors,” wrote Ali Aminian, MD, a surgeon with the Bariatric & Metabolic Institute at Cleveland Clinic, and colleagues. “However, no studies have examined the association between metabolic surgery procedures and incident major adverse cardiovascular events (MACEs) or death in patients with OSA.”
With this knowledge gap in mind, Aminian et al. tracked data from 970 patients who underwent Roux-en-Y gastric bypass (RYGB) or sleeve gastrectomy (SG) from 2004 to 2018 in Ohio or Florida. Sixty-six percent of those patients underwent RYGB, and 34% underwent SG.
This group was compared to more than 12,000 obese OSA patients who never underwent bariatric surgery. The mean age of all 13,657 patients was 52 years old.
The study’s primary endpoint was the overall MACE rate after 10 years. MACEs were defined as the first occurrence of coronary artery events, cerebrovascular events, heart failure, atrial fibrillation or all-cause mortality. Overall, the 10-year MACE rate was 27% in the metabolic surgery group and 35.6% in the nonsurgical group.
Ten-year all-cause mortality rates were 9.1% for the metabolic surgery group and 12.5% for the nonsurgical group. In addition, metabolic surgery was linked to “significantly lower” rates of heart failure and coronary artery events.
In terms of weight loss, meanwhile, patients who underwent metabolic surgery were linked to a reduction in body weight of 24% compared to 4.7% for the nonsurgical group.
“The current management guidelines of OSA recommend weight loss and lifestyle modifications,” the authors wrote. “Our findings support these recommendations. However, rather than focusing on lifestyle modification alone, treating obesity with more effective and durable methods may be required to improve cardiovascular outcomes and survival in patients with OSA and obesity. In the current study, patients maintained near 25% weight loss 10 years after metabolic surgery. In a holistic approach to patients with OSA and obesity who are at risk for other cardiometabolic and health consequences of obesity, metabolic surgery would be a reasonable choice in select patients.”
Click here to read the full analysis in the Journal of the American College of Cardiology.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.