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. 2013 Jul;30(7):684-96.
doi: 10.1007/s12325-013-0045-0. Epub 2013 Jul 30.

Reduction in Framingham risk of cardiovascular disease in obese patients undergoing laparoscopic adjustable gastric banding

Joan A Largent  1 , Joseph Vasey, Leona Bessonova, Ted Okerson, Nathan D Wong
Affiliations

Reduction in Framingham risk of cardiovascular disease in obese patients undergoing laparoscopic adjustable gastric banding

Joan A Largent et al. Adv Ther. 2013 Jul.

Abstract

Background: Obesity is a major risk factor for cardiovascular disease (CVD), with weight loss offering improvement in CVD risk factors.

Aims: To examine whether weight loss in laparoscopic adjustable gastric band (LAGB)-treated obese patients is associated with meaningful reductions in estimated 10- and 30- year Framingham CVD risk 12-15 months post-LAGB.

Methods: Obese adult patients [body mass index (BMI) ≥30 kg/m²] treated with LAGB were identified in a large US healthcare database. Patients without CVD at baseline and with measures of BMI, systolic blood pressure, diabetes, and smoking status at baseline and follow-up were eligible. Non-LAGB patients were propensity score matched to LAGB patients on baseline BMI, age, and gender. Estimated 10- and 30-year risk of developing CVD using office-based data, including BMI, was calculated at baseline and 12-15 months follow-up.

Results: Mean BMI in LAGB patients (n = 647, average age 45.66 years, 81.1% female) decreased from 42.7 to 33.4 kg/m² (P < 0.0001), with 35.4% no longer obese; 10- and 30-year estimated CVD risk decreased from 10.8 to 7.6% (P < 0.0001) and 44.34 to 32.30% (P < 0.0001), respectively, 12-15 months post-LAGB. Improvements were significantly greater than in non-LAGB patients (N = 4,295) (P < 0.0001). In the subset with lipid data (n = 74), improvements in total (-20.6 mg/dL; P < 0.05) and high-density lipoprotein (+10.6 mg/dL, P < 0.0001) cholesterol 1 year post-LAGB were also observed.

Conclusions: Data from a US healthcare database show that individuals undergoing LAGB have significant weight loss and reductions in estimated 10- to 30-year CVD risk within 1 year post-LAGB.

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Figures

Fig. 1
Fig. 1
Relative change in CVD risk factors, and estimated 10- and 30-year CVD risk at 12–15 months. BMI body mass index, CVD cardiovascular disease, HDL high-density lipoprotein, LAGB laparoscopic adjustable gastric banding, SBP systolic blood pressure. Asterisk estimated 10- and 30-year CVD risk calculated using office-based algorithms for all patients, and using lipid-based algorithms for patients with lab measures [18, 19]
Fig. 2
Fig. 2
Change in estimated 10- and 30-year CVD risk at 12–15 months, LAGB versus non-LAGB patients. CVD cardiovascular disease, LAGB laparoscopic adjustable gastric banding. P values reported for difference between LAGB and non-LAGB patients. Asterisk estimated 10- and 30-year CVD risk calculated using office-based algorithms for all patients, and using lipid-based algorithms for patients with lab measures [18, 19]
Fig. 3
Fig. 3
Change in estimated 10- and 30-year CVD risk at 12–15 months by gender and baseline BMI. BMI body mass index, CVD cardiovascular disease, LAGB laparoscopic adjustable gastric banding. *P < 0.05 for changes from baseline between LAGB and non-LAGB groups; BMI was presented as kg/m2
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