Reduced Risk of Cardiovascular Diseases After Bariatric Surgery Based on the New Predicting Risk of Cardiovascular Disease EVENTs Equations

BACKGROUND: We applied the novel Predicting Risk of Cardiovascular Disease EVENTs equations to evaluate cardiovascular– kidney–metabolic (CKM) health and estimated cardiovascular disease (CVD) risk after bariatric surgery. METHODS: Among 7804 patients (aged 20–79 years) undergoing bariatric surgery at Vanderbilt University Medical Center during 1999 to 2022, CVD risk factors from before surgery to 2 years after surgery were extracted from electronic health records. The 10-and 30-year risks of total CVD, atherosclerotic CVD, coronary heart disease, stroke, and heart failure (HF) were estimated for patients without CVD history at each time point (n=124–2910), using the social deprivation index–enhanced Predicting Risk of Cardiovascular Disease EVENTs equations. Paired t tests or McNemar tests were used to compare pre-with postsurgery CKM health and CVD risk. Two-sample t tests were used to compare CVD risk reduction between patient subgroups. RESULTS: CKM health was significantly improved after surgery with lower systolic blood pressure, non–high-density lipoprotein cholesterol, and diabetes prevalence, and higher high-density lipoprotein and estimated glomerular filtration rate. The 10-year risks of total CVD and its subtypes decreased by 21.7% to 56.3% at 1 year after surgery and by 14.6% to 46.5% at 2 years after surgery, with the largest reduction observed for HF. Younger age, White race, >30% weight loss, and diabetes history were associated with greater HF risk reductions. Similar results were found for the 30-year CVD risk estimates. CONCLUSIONS: Bariatric surgery significantly improves CKM health and reduces estimated CVD risk, particularly HF, by 47% to 56% within 1 to 2 years after surgery. HF risk reduction may vary by patient’s demographics, weight loss, and disease history, which warrants further research.