title: Effect of bariatric surgery on cardiometabolic risk in elderly patients: A population-based study.
abstract: OBJECTIVE
  Obesity is a major cardiovascular (CV) risk factor. Bariatric surgery (BSx) is an approved therapeutic alternative for class II-III obesity, but little evidence focuses on older adults. We assessed the effect of BSx on cardiometabolic variables and long-term CV risk in older adults.
  
  
  METHODS
  We carried out a population-based, observational study from 1990-2009, of 40 consecutive elderly (age ≥60 years) residents of Olmsted County, MN, USA, with class II-III obesity treated with BSx at a University-based, academic health center. Data were obtained from the Rochester Epidemiology Project. Metabolic syndrome (MetS) was defined using American Heart Association/National Heart, Lung, Blood Institute (AHA/NHLBI) criteria (increased triglycerides, low high-density lipoprotein, increased blood pressure, increased glucose and body mass index as a modified measure of obesity instead of waist circumference). Change in CV risk factors, MetS prevalence, and impact on predicted CV risk using the Framingham risk score was ascertained at 1 year postoperatively and assessed statistically.
  
  
  RESULTS
  Mean age and body mass index were 64.4 ± 3.7 and 45.0 ± 6.3 kg/m(2) , respectively, and 28 out of 40 (70%) were women. One participant died during the 11-month study period after BSx from respiratory complications related to BSx, and one participant died at 2 years. Percentage of excess weight loss decreased by 57.5% at 1 year. Prevalence 1 year after BSx decreased for diabetes (57.5% to 22.5%; P < 0.03), hypertension 87.5% to 73.7% (P = 0.003), dyslipidemia (80% to 42.5%; P < 0.001) and sleep apnea (62.5% to 23.7%; P < 0.001).MetS prevalence decreased from 80% to 45% (P < 0.002). Baseline risk was 14.1%, which changed at follow up at 8.2%.
  
  
  CONCLUSIONS
  In older adults, BSx induces considerable weight loss, improves CV risk factors, decreases MetS prevalence and is an effective treatment in this population. Geriatr Gerontol Int 2016; 16: 618-624.
authors.affiliation: Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, Hanover, New Hampshire, USA.|Centers for Health and Aging, Dartmouth College, Hanover, New Hampshire, USA.|Geisel School of Medicine at Dartmouth and The Dartmouth Institute for Health Policy & Clinical Practice, Hanover, New Hampshire, USA.
authors.forename: John A
authors.identifier: http://orcid.org/0000-0002-0845-4416
authors.initials: JA
authors.lastname: Batsis
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: William R
authors.initials: WR
authors.lastname: Miranda
authors.affiliation: Division of Endocrinology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
authors.forename: Chaithra
authors.initials: C
authors.lastname: Prasad
authors.affiliation: Division of Endocrinology, Diabetes and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Collazo-Clavell
authors.affiliation: Department of Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sarr
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Virend K
authors.initials: VK
authors.lastname: Somers
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Lopez-Jimenez
mesh_terms: D000368:Aged; D050110:Bariatric Surgery; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000517:prevention & control; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000601:surgery*; D015995:Prevalence; D012307:Risk Factors; D015431:Weight Loss
keywords: Framingham risk; bariatric surgery; elderly; metabolic risk