Background
The Framingham risk score estimates 10-year coronary heart disease (CHD) risk based
on gender, age, smoking status, blood pressure, TC, HDL-C, and diabetes mellitus status.
It was designed to be independent of weight, and as such it is the ideal model to
estimate the impact of bariatric surgery on the change in this risk. Our study evaluates
the effect of gastric bypass on the prevalence of CHD risk factors and then utilizes
the Framingham risk score to estimate the postoperative reduction in 10-year CHD risk.
Methods
Retrospectively, 101 consecutive patients who underwent laparoscopic Roux-en-Y gastric
bypass were reviewed. The 10-year CHD risk was calculated using historic, biometric,
and laboratory data.
Results
The mean body mass index decreased from 46.9 ± 5.8 kg/m2 preoperatively to 28.7 ± 4.0 kg/m2 one year postoperatively. All physical and biochemical markers of cardiac risk improved
significantly. Systolic blood pressure fell from 143 ± 20 mmHg to 123 ± 18 mmHg (14%)
and diastolic blood pressure fell from 81 ± 10 mmHg to 71 ± 11 mmHg (12%). Total cholesterol
declined from 202 to 165 (18%); LDL-C declined from 118 to 97 (18%); and HDL-C increased
from 45 to 51 (14%). The overall 10-year CHD risk decreased from 6.7 ± 5.5% to 3.2
± 3.1%, representing an absolute risk reduction of 3.3% or relative risk reduction
of 52%. This risk reduction was similar in subgroups based on preoperative CHD risk
or on initial BMI.
Conclusions
Using the Framingham risk score we show that gastric bypass surgery reduces 10-year
coronary risk by more than half. Additionally, to the increasing evidence of the salutary
effect gastric bypass surgery has on CHD risk, we contribute assessment of 10-year
risk in subjects at stable weight loss and within the Framingham model's validated
parameters.
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Article info
Publication history
Published online: January 31, 2008
Accepted:
October 17,
2007
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
