The Impact of Ethnicity on Cardiovascular Risk Reduction and Heart Age After Bariatric Surgery.


Journal

Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714

Informations de publication

Date de publication:
May 2020
Historique:
pubmed: 19 2 2020
medline: 15 4 2021
entrez: 19 2 2020
Statut: ppublish

Résumé

Risk factors for heart disease include arterial hypertension, high cholesterol, tobacco abuse, and obesity. There is a paucity of data regarding role of ethnicity in bariatric surgery (BS) outcomes. The study's aim is to determine if ethnicity plays a significant role in BS outcomes, heart age, and cardiovascular risk. We conducted a retrospective review of data collected concurrently from patients who underwent BS from 2010 to 2015. We analyzed demographics, comorbidities, heart age, and cardiovascular risk-score at surgery and 12-month follow-up. Ethnicities categorized were Caucasian and African American. Heart age was calculated using the Framingham Study Heart Age Calculator and cardiovascular risk-score using the Atherosclerotic Cardiovascular Disease Risk Calculator. A total of 292 patients presented all the variables needed to calculate heart age and cardiovascular risk score. This patient population was composed of 85% Caucasians and 15% African American. Female gender represented 67% (N = 202) of patients with mean age of 52.6 ± 10.7 years. LSG was the most prevalent procedure performed in 73.2% (N = 213) of patients. Mean BMI pre-operatively versus post-operatively by ethnicity was 41.46 ± 4.66 vs 30.08 ± 4.34 Caucasians and 41.90 ± 4.69 vs 32.08 ± 4.68 African Americans. Mean heart age pre-operatively versus post-operatively by ethnicity was 71.35 ± 14.59 vs 62.45 ± 16.12 (p < 0.0001) for Caucasians and 71.38 ± 14.30 vs 65.91 ± 16.61 (p = 0.11) for African Americans. The mean cardiovascular risk scores pre-operatively versus post-operatively by ethnicity were 0.24 ± 0.20 vs 0.15 ± 0.14 (p < 0.0001) for Caucasians and 0.20 ± 0.19 vs 0.16 ± 0.17 (p = 0.23) for African Americans. Ethnicity does not seem to impact weight loss after BS. However, we found a significant ethnicity-elated difference in reduction of heart age and cardiovascular risk.

Sections du résumé

BACKGROUND BACKGROUND
Risk factors for heart disease include arterial hypertension, high cholesterol, tobacco abuse, and obesity. There is a paucity of data regarding role of ethnicity in bariatric surgery (BS) outcomes. The study's aim is to determine if ethnicity plays a significant role in BS outcomes, heart age, and cardiovascular risk.
METHODS METHODS
We conducted a retrospective review of data collected concurrently from patients who underwent BS from 2010 to 2015. We analyzed demographics, comorbidities, heart age, and cardiovascular risk-score at surgery and 12-month follow-up. Ethnicities categorized were Caucasian and African American. Heart age was calculated using the Framingham Study Heart Age Calculator and cardiovascular risk-score using the Atherosclerotic Cardiovascular Disease Risk Calculator.
RESULTS RESULTS
A total of 292 patients presented all the variables needed to calculate heart age and cardiovascular risk score. This patient population was composed of 85% Caucasians and 15% African American. Female gender represented 67% (N = 202) of patients with mean age of 52.6 ± 10.7 years. LSG was the most prevalent procedure performed in 73.2% (N = 213) of patients. Mean BMI pre-operatively versus post-operatively by ethnicity was 41.46 ± 4.66 vs 30.08 ± 4.34 Caucasians and 41.90 ± 4.69 vs 32.08 ± 4.68 African Americans. Mean heart age pre-operatively versus post-operatively by ethnicity was 71.35 ± 14.59 vs 62.45 ± 16.12 (p < 0.0001) for Caucasians and 71.38 ± 14.30 vs 65.91 ± 16.61 (p = 0.11) for African Americans. The mean cardiovascular risk scores pre-operatively versus post-operatively by ethnicity were 0.24 ± 0.20 vs 0.15 ± 0.14 (p < 0.0001) for Caucasians and 0.20 ± 0.19 vs 0.16 ± 0.17 (p = 0.23) for African Americans.
CONCLUSIONS CONCLUSIONS
Ethnicity does not seem to impact weight loss after BS. However, we found a significant ethnicity-elated difference in reduction of heart age and cardiovascular risk.

Identifiants

pubmed: 32067167
doi: 10.1007/s11695-019-04341-1
pii: 10.1007/s11695-019-04341-1
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1679-1684

Références

Centers for Disease Control and Prevention. Heart Disease Facts [Internet]. 2012 [cited 2019 Apr 4]. Available from: http://www.cdc.gov/heartdisease/facts.htm
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Poirier P, Cornier MA, Mazzone T, Stiles S, Cummings S, Klein S, McCullough P, Ren Fielding C, Franklin BA, American Heart Association Obesity Committee of the Council on Nutrition, Physical Activity, and Metabolism. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation. 2011;123:1683–1701.
doi: 10.1161/CIR.0b013e3182149099
Elli EF, Gonzalez-Heredia R, Patel N, Masrur M, Murphey M, Chen J, et al. Bariatric surgery outcomes in ethnic minorities. Surg (United States) [Internet]. Elsevier Inc.; 2016;160:805–12. Available from: https://doi.org/10.1016/j.surg.2016.02.023
doi: 10.1016/j.surg.2016.02.023
Blanco DG, Funes DR, Giambartolomei G, Lo Menzo E, Szomstein S, Rosenthal RJ. High cardiovascular risk patients benefit more from bariatric surgery than low cardiovascular risk patients. Surg Endosc Other Interv Tech [Internet]. Springer US; 2018;0:0. Available from: https://doi.org/10.1007/s00464-018-6437-0 , 33, 1626, 1631
doi: 10.1007/s00464-018-6437-0
Mahmood SS, Levy D, Vasan RS, Wang TJ. The Framingham Heart Study and the epidemiology of cardiovascular disease: a historical perspective. Lancet (London, England). England; 2014;383:999–1008.
Goff DC, Lloyd-jones DM, Bennett G, et al. Reply: 2013 ACC/AHA guideline on the assessment of cardiovascular risk. J Am Coll Cardiol. 2014;63:2886.
doi: 10.1016/j.jacc.2013.11.005
Gutierrez-Blanco D, Funes-Romero D, Madiraju S, et al. Reduction of Framingham BMI score after rapid weight loss in severely obese subjects undergoing sleeve gastrectomy: a single institution experience. Surg Endosc Germany. 2018;32:1248–54.
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Rayner BL, Spence JD. Hypertension in blacks: insights from Africa. J Hypertens England. 2017;35:234–9.
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Shaw PM, Chandra V, Escobar GA, et al. Controversies and evidence for cardiovascular disease in the diverse Hispanic population. J Vasc Surg United States. 2018;67:960–9.
doi: 10.1016/j.jvs.2017.06.111

Auteurs

Cristian Milla (C)

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.

María Fonseca (M)

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.

David Gutierrez (D)

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.

David Romero (D)

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.

Emanuele Lo Menzo (E)

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.

Robert Cubeddu (R)

Department of General and Interventional Cardiology, Cleveland Clinic Florida, Weston, USA.

Samuel Szomstein (S)

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.

Raúl J Rosenthal (RJ)

Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA. ROSENTR@ccf.org.

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