Photo of a Lap Band
Patients undergoing Lap Band or Weight Loss Surgery had a significantly reduced rate of subsequent myocardial infarctions and strokes and significantly increased survival, compared with similar, morbidly obese patients who had other types of surgery, in a retrospective cohort study of more than 9,000 U.S. patients. In his study of bariatric surgery patients in South Carolina during 1996-2008, the combined rate of MIs, strokes, and deaths was 52% below the rate in patients undergoing gastrointestinal surgery, and 28% below the rate of those who had orthopedic surgery – both statistically significant differences. The results also showed significant drops in each component of the combined end point (MIs, strokes, and deaths).
The new study used hospital in-patient records collected during 1996-2008 through the South Carolina Office of Research and Statistics, and death data collected by the South Carolina Department of Health and Environmental Control. The analysis included morbidly obese patients aged 40-79 years who underwent nonemergency surgery (4,747 patients who had any form of bariatric surgery, 3,066 patients who underwent joint replacement or spinal surgery, and 1,327 patients who had a cholecystectomy, hernia repair, or lysis of gastrointestinal adhesions). Those with a history of prior MI or stroke were excluded.
Patients were followed for an average of 14 months after lap band surgery, 25 after orthopedic surgery, and 26 months after gastrointestinal surgery.
In a multivariate analysis that controlled for age, sex, race, hypertension, dyslipidemia, diabetes, coronary artery disease, obstructive sleep apnea, and a history of transient ischemic attack, patients undergoing bariatric surgery had a significant 41% reduced rate of first MI compared with the orthopedic surgery patients, and a significant 51% lower rate compared with the gastrointestinal surgery patients. Mortality in the weight loss surgery Los Angeles patients dropped by a significant 19% and 55% relative to the orthopedic and gastrointestinal patients, respectively, and the stroke rate was also significantly lower following bariatric surgery compared with the rates in each control group. The magnitude of these event-rate reductions was consistent with prior reports of risk reduction. Notably, bariatric surgery “reduced cardiovascular events, as opposed to obesity-drug treatments that may actually increase the risk for cardiovascular events,” he noted. “Bariatric surgery has been rigorously tested and [proved] over the past 20 years, and it has a dramatic effect on all aspects of patient health. [Most] medical treatments for obesity don’t have 20 years of data, and some medications actually cause heart problems. We don’t know how bariatric surgery reduced myocardial infarctions and strokes, but it’s probably several factors: weight loss and resolution of diabetes, hypertension, and sleep apnea. The spectrum of returning patients to a more normal, baseline state probably leads to less morbidity and mortality,” said one the best weight loss surgeon
Obese people who had weight-loss surgery were less likely to later suffer a heart attack or stroke, or to die from one, compared to people who did not have the surgery, according to a Swedish study. Between 1987 and 2001, half of those people opted for bariatric or weight-loss surgeries, most often stomach stapling, and the other half were treated with routine care, including advice on lifestyle changes. Compared with usual care, bariatric surgery was associated with reduced number of cardiovascular deaths and lower incidence of cardiovascular events in obese adults.
In total, 199 who underwent bariatric surgery had their first heart attack or stroke, and 28 died as a result. By comparison, 234 people who decided against the surgery suffered a heart attack or stroke, and 49 died.One reason is that the surgery has other health benefits independent of the amount of weight loss, including a reduction in diabetes, which could ease heart risks — all things to consider when deciding whether to have surgery