Distribution of 10-year and lifetime predicted risk for cardiovascular disease prior to surgery in the longitudinal assessment of bariatric surgery-2 study

Rachel H. MacKey, Steven H. Belle, Anita P. Courcoulas, Greg F. Dakin, Clifford W. Deveney, David R. Flum, Luis Garcia, Wendy C. King, Lewis H. Kuller, James E. Mitchell, Alfons Pomp, Walter J. Pories, Bruce M. Wolfe

Research output: Contribution to journalArticle

15 Scopus citations

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/m2. 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.

Original languageEnglish (US)
Pages (from-to)1130-1137
Number of pages8
JournalAmerican Journal of Cardiology
Volume110
Issue number8
DOIs
StatePublished - Oct 15 2012

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

MacKey, R. H., Belle, S. H., Courcoulas, A. P., Dakin, G. F., Deveney, C. W., Flum, D. R., Garcia, L., King, W. C., Kuller, L. H., Mitchell, J. E., Pomp, A., Pories, W. J., & Wolfe, B. M. (2012). Distribution of 10-year and lifetime predicted risk for cardiovascular disease prior to surgery in the longitudinal assessment of bariatric surgery-2 study. American Journal of Cardiology, 110(8), 1130-1137. https://doi.org/10.1016/j.amjcard.2012.05.054