Monday, April 5, 2021 (American Heart Association News)-Obesity surgery makes a difficult decision to treat obesity as patients and their physicians weigh the benefits of weight loss that normally follow and the risks and side effects of the procedure. There is a possibility of becoming.
Heart disease adds another factor to the risk and benefit analysis. Is surgery a good idea for people who already have cardiovascular problems?
A new study published Monday in the American Heart Association’s journal Circulation suggests so. A Canadian study found that participants with cardiovascular disease and severe obesity (body mass index greater than 40) who underwent obesity surgery had fewer major cardiovascular events than people with similar conditions who did not undergo surgery. Was shown. Few people died.
Dr. Mehran Anvari, a professor of surgery at McMaster University in Hamilton, Ontario and the lead author of the study, said: “I think it’s good to see if there are any differences between patients who have had surgery compared to those who have been qualified but have not been referred or have not undergone surgery. I did. “
From Ontario medical records, researchers matched 1,319 people with heart disease or heart failure who had surgery for obesity with the same number of people in similar situations who did not have surgery. After a median follow-up of 4.6 years, about 20% of those who did not have surgery compared to about 12% of those who had surgery, from heart attack and stroke to hospitalization for heart failure and general death. And experienced harmful consequences. This means a 42% reduction in risk.
“Therefore, we can certainly see that obesity surgery has a higher return than additional risk,” said Anvari.
Dr. Christine Len Fielding, director of obesity surgery at NYU Langone Health Center, said he was not surprised at the results.
“The lesson of this story is that if you have heart disease due to morbid obesity, and if you haven’t had obesity surgery, you’re more likely to have heart problems in the future,” Renfielding said. Stated. Those who were not involved in the study. “You can look at the data here and see that it actually supports what we already believed in.”
Obesity surgery involves various steps to reduce the size of the stomach, alter the pathways of the digestive tract, and limit the amount of food that can be eaten and the body’s ability to absorb nutrients. By combining diet and exercise, weight loss surgery can result in significant weight loss and reduce the risk of health problems such as heart disease, stroke, type 2 diabetes, and high blood pressure.
“If you’re underweight, your heart works less to pump blood,” Ambari said. “Therefore, it puts less strain on the heart, but it also improves other cardiovascular risk factors, such as lowering triglycerides and cholesterol.”
However, the risk of surgery can extend to responses to anesthesia and infections with hernias, blood clots, and malnutrition. According to Amberi, some doctors have traditionally been reluctant to recommend obesity surgery to people with cardiovascular disease or who have already had a heart attack, and either cannot tolerate the surgery or have complications from anesthesia. I’m afraid that it might be.
He said those attitudes originated in the early days of obesity surgery, which was more invasive and complex than most procedures today and required longer recovery. “Today, these are done laparoscopically,” Ambari said. “Some people can go home the same day or the next day.”
The new study is a retrospective cohort study that looks back on patient outcomes. According to Anvari, his team has already begun follow-up on randomized controlled trials, providing a higher level of evidence by selecting patient groups to compare and eliminating bias in future follow-up. To do.
“This is Level 2 evidence, and now we need Level 1 evidence,” he said.
For now, Ren Fielding, a professor of surgery at New York University’s Grossman School of Medicine, said the new study should help her get rid of persistent stigma and fear of obesity surgery.
“This is an important tip,” she said.
American Heart Association News Covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyrighted by American Heart Association, Inc. Owned or owned by, and all rights reserved. If you have any questions or comments about this story, please email [email protected]
By Michael Precker
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