Structural and functional vascular improvement 1 year after bariatric surgery: a prospective cohort study

Obesity is a major risk factor for cardiovascular disease. Data on structural and functional arterial changes after bariatric surgery are scarce.

The aim of this study was to determine the effects of bariatric surgery on the carotid intima media thickness (cIMT) and pulse wave velocity (PWV).

General hospital.

We collected data prospectively in 200 patients scheduled for bariatric surgery between 2015-2017. Based on an increase or decrease of 1 standard deviation of the mean difference in cIMT and PWV 1 year postoperatively, patients were divided into progressors, regressors', and unchanged. We analyzed data on medical history, baseline body mass index, surgery type, and difference in body mass index after 1 year.

Data on cIMT were available for 134 patients. Thirty-four patients (25.4%) had a cIMT regression with a mean decrease of .1 mm (-.24 to -.06), 10 patients (7.5%) were progressors with a mean increase of .1 mm (.07-.30), and 90 patients (67.2%) remained unchanged. Progressors more often had type 2 diabetes (P = .035) and hypertension (P = .020). Data on PWV were available for 120 patients, of whom 91 (75.8%) were regressors, 26 (21.6%) remained unchanged, and 3 (2.5%) were progressors. Predictors of PWV changes were total plasma cholesterol and hypertension at baseline.

A significant improvement of the vascular quality already after 1 year of follow-up was established in 25%-76% of all patients after bariatric surgery and the vast majority showed stabilization.