A 2018 HCSRN study, including Kaiser Permanente Washington, showed that bariatric surgery was linked to a significant reduction of heart problems in patients with obesity and diabetes. What distinguishes this new study is that it measured more outcomes, including atrial fibrillation and kidney disease.
The primary endpoint of the new study was the occurrence of death or one of five major complications associated with obesity and diabetes—coronary artery events, cerebrovascular events, heart failure, atrial fibrillation, and kidney disease:
- Over an eight-year period, patients undergoing metabolic surgery were 40 percent less likely to experience one of these events than those receiving usual medical care.
- Patients in the surgical group were 41 percent less likely to die from any cause.
“The striking results that we saw after metabolic surgery may be related to the patients’ substantial and sustained weight loss,” says Ali Aminian, MD, a bariatric surgeon at Cleveland Clinic and lead author of the new study. “However, there is a growing body of evidence to suggest that there are beneficial metabolic and hormonal changes after these surgical procedures that are independent of weight loss.”
Compared with the non-surgery group, patients who had metabolic surgery had an average of 15 percent more weight loss and lower blood sugar levels. They also needed less diabetes medications, including insulin, and less heart medications such as blood pressure and cholesterol therapies.
“Cardiovascular complications from obesity and diabetes can be devastating. Now that we’ve seen these remarkable results, a well-designed randomized controlled trial is needed to definitively determine whether metabolic surgery can reduce the incidence of major heart problems in patients with type 2 diabetes and obesity,” says the study’s senior author Steven Nissen, MD, chief academic officer of Cleveland Clinic’s Heart & Vascular Institute.