The rate of obesity is rising logarithmically, especially morbid obesity (BMI > 40 kg/m2). Obesity is commonly associated with multiple conditions imparting adverse cardiovascular risk including, hypertension, dyslipidemia and diabetes. Severe obesity is generally refractory to lifestyle modification, including diet, exercise and pharmacological treatment.
The main objective of the study is to confirm the use of bariatric surgery as a means to reduce cardiovascular risk in severely obese patients.
We examined 164 patients with morbid obesity (BMI > 40 kg/m2), they formed two groups. The first group included 81 patients who treated with diet, physical activity and drugs. The second group included 83 patients who using bariatric surgery (gastric bypass). Patients were examined before and after 6 months of treatment. All patients underwent clinical examination, determination of anthropometric parameters, measurement office SBP and DBP, daily monitoring of blood pressure, echocardiography, exploration indicators carbohydrate and lipid metabolism, definition cardiovascular risk with using scales SCORE, PROCAM, DRS, FRAMINGHAM.
It was found that after 6 months of treatment weight loss was observed in both groups. A more significant decrease in body weight was observed in patients after surgical treatment (in first group by 4.6%, in the second group by 22.8%). Weight loss in patients after surgical treatment was associated with a greater decrease in blood pressure, improvement in the daily BP profile, changes in the structural and functional characteristics of the myocardium, decrease in the number of patients with LV hypertrophy, decrease LDL cholesterol, TG, glucose level, which was accompanied by a decrease in the number of patients with glucose intolerance (by 41.2%) and with diabetes (by 75%). Weight loss was associated with reducing the number of patients at very high risk on a scale SCORE by 78%, on a scale PROCAM by 100%, on a scale FRAMINGHAM by 95,6% and on a scale DRS by 13% in patients after surgical treatment.
Weight loss with the use of bariatric surgery contributes to the normalization of BP, reduces LV hypertrophy, has a positive effect on the lipid, carbohydrates profile and reduces cardiovascular risk.
1NSC M.D. Strazhesko institute of cardiology, Kiev, Ukraine
2National Institute of Surgery and Transplantation A.A.Shalimova, Kiev, Ukraine