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September 5, 2008 – 2:25 pm -Weightloss
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Published by Noel Crowe.
September 5, 2008
Effect of Weight Loss Surgery Outcomes on Cardiovascular Risk
Weight-loss surgery appears to be the most effective solution available for people who are extremely obese. It reverses, reduces or eliminates major cardiovascular risk factors, including hypertension and lipid disturbances.
People who have had this surgery up to 14 years ago have been followed through and significant weight loss has been achieved greater than 50% of body weight in 90% of patients who underwent the operation.
Weight loss has been shown to significantly improve heart function, decreasing cardiac risk and medication requirements in 80-92% of patients.
Obesity leads to abnormal changes in heart function, and is associated with higher biventricular mass and end-diastolic volume in both adults and adolescents. Significantly, obesity is associated with enlargement of the aorta and decreased aortic elasticity. This structural abnormality might contribute to the increase in cardiovascular risks related to underlying obesity.
Weight loss , even when achieved by diet, has been shown to improve left-ventricular diastolic filling of the hearts chambers and improved ejection fraction. In addition, substantial weight loss produced by bariatric surgery appears to reverse many of the electrocardiographic abnormalities associated with morbid obesity.
The majority of patients with congestive heart failure symptoms show improvement within 1-2 weeks of surgery, after losing the fluid which has been retained in their body, typically within 4-8 weeks after the operation or on achievement of just 10% weight loss. This weight loss of around 10% of initial body weight, improves many functions including lessening inflammatory problems and reducing clotting risk.
Weight loss surgery resolves type 2 diabetes in 75-85% of patients, with significant improvement in 95%. This surgery normalizes lipid profiles and improves ventricular function in 100% of patients.
Obstructive sleep apnoea is a common finding among morbidly obese patients and has a potentially serious impact on cardiovascular fitness. In almost all cases, however, weight loss achieved by bariatric procedures improves obstructive sleep apnea to the point of eliminating the need for continuous positive airway pressure, with no apnea in 40% of patients and minimal episodes in 60%.
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