Gastric Bypass May Cut Heart Failure Risk in Half

In the last two weeks, two new, independent studies with large cohorts of gastric bypass patients are pointing to the same benefit. Gastric bypass appears to cut heart failure risk in half.

One of the many major complications of obesity is heart disease. The end stage of heart disease is heart failure. After years of hypertension, coronary artery disease, and perhaps a heart attack, the heart can simply no longer do its job. It cannot pump enough blood to meet the body’s needs. It’s manageable, but not curable. It’s costly and often fatal.

So the news that gastric bypass can cut the risk of heart failure in half is good news indeed.

The Scandinavian Obesity Surgery Registry

This study followed a cohort of  25,804 gastric bypass patients for a median of four years. Matched controls (13,701) received intensive lifestyle therapy. The researchers found the incidence of heart failure was approximately halved for gastric bypass patients compared to the intensive lifestyle therapy group.

Researchers attributed the reduction in heart failure to weight loss and to its effect on atrial fibrillation, diabetes, and hypertension. Johan Sundström and colleagues published their study in Circulation.

The Geisinger Cohort

Peter Benotti and colleagues followed a cohort of 3,448 bypass patients and matched controls in the Geisinger Health System for up to twelve years after surgery. The matched controls were eligible for bypass surgery, but received only medical care for obesity.

Researchers found a sustained reduction in the risk of congestive heart failure. The risk of a major adverse cardiovascular event was half for bypass patients versus similar patients receiving nonsurgical care. They published their findings in the Journal of the American Heart Association.

A Growing Gap Between Evidence and Access to Care

Both of these findings come from cohort studies, not randomized trials. Randomized studies of surgery are challenging and less common. These cohort studies help to complete the picture of bariatric surgery’s benefits and risks. And the body of evidence for the cardiovascular benefits of gastric bypass surgery is growing so that it’s hard to dismiss.

And yet, many barriers to having bypass surgery remain. They include pre-authorization procedures that serve to delay, discourage, and stigmatize people who need this surgery. They include the misconception that surgery is “an easy way out.” They include fear mongering about risks of the surgery.

The Canadian Obesity Network estimates that bariatric surgery is available to only 0.54% of Canadians who may need it.

Such limited access to such an important, potentially life-saving procedure is indefensible.

Click here for the study by Sundström et al and  here for the study by Benotti et al.

Bleeding Heart, photograph © Ingrid Taylar / flickr

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May 28, 2017