title: Distribution of 10-year and lifetime predicted risk for cardiovascular disease prior to surgery in the longitudinal assessment of bariatric surgery-2 study.
abstract: Primary prevention guidelines recommend calculation of lifetime cardiovascular disease (CVD) predicted risk in patients who may not meet criteria for high short-term (10-year) Adult Treatment Panel III risk for coronary heart disease (CHD). Extreme obesity and bariatric surgery are more common in women who often have low short-term predicted CHD risk. The distribution and correlates of lifetime CVD predicted risk, however, have not yet been evaluated in bariatric surgical candidates. Using established 10-year (Adult Treatment Panel III) CHD and lifetime CVD risk prediction algorithms and presurgery risk factors, participants from the Longitudinal Assessment of Bariatric Surgery-2 study without prevalent CVD (n = 2,070) were stratified into 3 groups: low 10-year (<10%)/low lifetime (<39%) predicted risk, low 10-year (<10%)/high lifetime (≥39%) predicted risk, and high 10-year (≥10%) predicted risk or diagnosed diabetes. Participants were predominantly white (86%) and women (80%) with a median age of 45 years and median body mass index of 45.6 kg/m(2). High 10-year CHD predicted risk was common (36.5%) and associated with diabetes, male gender, and older age, but not with higher body mass index or high-sensitivity C-reactive protein. Most participants (76%) with low 10-year predicted risk had high lifetime CVD predicted risk, which was associated with dyslipidemia and hypertension but not with body mass index, waist circumference, high-density lipoprotein cholesterol, or high-sensitivity C-reactive protein. In conclusion, bariatric surgical candidates without diabetes or existing CVD are likely to have low short-term, but high lifetime CVD predicted risk. Current data support the need for long-term monitoring and treatment of increased CVD risk factors in bariatric surgical patients to maximize lifetime CVD risk decrease (clinical trial registration, Long-term Effects of Bariatric Surgery, indentifier NCT00465829, available at: http://www.clinicaltrials.gov/ct2/results?term=NCT00465829).
authors: University of Pittsburgh Graduate School of Public Health, Pennsylvania, USA. mackey@edc.pitt.edu
authors: Rachel H
authors: RH
authors: Mackey
authors: Steven H
authors: SH
authors: Belle
authors: Anita P
authors: AP
authors: Courcoulas
authors: Greg F
authors: GF
authors: Dakin
authors: Clifford W
authors: CW
authors: Deveney
authors: David R
authors: DR
authors: Flum
authors: Luis
authors: L
authors: Garcia
authors: Wendy C
authors: WC
authors: King
authors: Lewis H
authors: LH
authors: Kuller
authors: James E
authors: JE
authors: Mitchell
authors: Alfons
authors: A
authors: Pomp
authors: Walter J
authors: WJ
authors: Pories
authors: Bruce M
authors: BM
authors: Wolfe
mesh_terms: D000328:Adult; D000367:Age Factors; D000465:Algorithms; D050110:Bariatric Surgery; D015415:Biomarkers / Q000032:analysis; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009749:Nutrition Surveys; D015995:Prevalence; D011322:Primary Prevention; D012307:Risk Factors; D012737:Sex Factors; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers