Structural and functional vascular improvement 1 year after bariatric surgery: a prospective cohort study.

Background: Obesity is a major risk factor for cardiovascular disease. Data on structural and functional arterial changes after bariatric surgery are scarce.

Objectives: The aim of this study was to determine the effects of bariatric surgery on the carotid intima media thickness (cIMT) and pulse wave velocity (PWV).

Setting: General hospital.

Methods: We collected data prospectively in 200 patients scheduled for bariatric surgery between 2015-2017. Based on an increase or decrease of 1 standard deviation of the mean difference in cIMT and PWV 1 year postoperatively, patients were divided into progressors, regressors', and unchanged. We analyzed data on medical history, baseline body mass index, surgery type, and difference in body mass index after 1 year.

Results: Data on cIMT were available for 134 patients. Thirty-four patients (25.4%) had a cIMT regression with a mean decrease of .1 mm (-.24 to -.06), 10 patients (7.5%) were progressors with a mean increase of .1 mm (.07-.30), and 90 patients (67.2%) remained unchanged. Progressors more often had type 2 diabetes (P = .035) and hypertension (P = .020). Data on PWV were available for 120 patients, of whom 91 (75.8%) were regressors, 26 (21.6%) remained unchanged, and 3 (2.5%) were progressors. Predictors of PWV changes were total plasma cholesterol and hypertension at baseline.

Conclusions: A significant improvement of the vascular quality already after 1 year of follow-up was established in 25%-76% of all patients after bariatric surgery and the vast majority showed stabilization.