[Evaluation of cardiovascular risk factors in obesity before and after bariatric surgery]

Mexico has one of the highest prevalences of severe obesity worldwide. Mortality in those patients may be as high as 90% mainly due to cardiovascular disease. Despite Framingham score has been validated in the Mexican population, it only predicts cardiovascular risk at 10 years. Meanwhile ASCVD10 score could evaluate risk at 10 years and through lifetime. None of these scores have been used for cardiovascular risk assessment in Mexican patients with severe obesity.

We conducted a quasi-experimental (before/ after) study with 109 patients with severe obesity, assessed prevalence of comorbidities, performed anthropometric and biochemical evaluations before and a year after bariatric surgery. With these results we calculated Framingham and ASCVD10 scores and compared them.

Patients had a mean age of 45.3 ± 10.1 years, 70% female, 79% underwent laparoscopic Roux-en-Y gastric bypass. We observed weight decrease at each evaluation point after surgery, independently of the surgical procedure. All biochemical parameters improved. Framingham score decreased from 9.4% to 5.9%, frequency of patients classified as high-risk decreased from 25% to 11%. ASCVD10 score decreased from 4.1% to 2.5%, patients classified as high-risk decreased from 28% to 16%. Tobacco use was the most important factor involved in cardiovascular risk.

Cardiovascular risk at 10-years and lifetime decreased as soon as one year after surgery as assessed through Framingham and ASCVD scores.