The effectiveness of bariatric surgery on reducing the prevalence and severity of obesity-related comorbidities has been well established. Diastolic heart failure (DHF) is an increasingly common condition associated with considerable morbidity and mortality, yet recalcitrant to treatment. Our objectives were to assess whether bariatric surgery (BaS) is associated with a decreased incidence of DHF, and further assess its impact upon DHF-incidence among patients with hypertension (HTN) and coronary artery disease (CAD).
The US National Inpatient Sample (NIS) database was queried for obesity, BaS, DHF, HTN, CAD for the years 2010-2015. Univariate and multivariable analysis were performed to assess the impact of BaS on the incidence of hospital admissions for DHF, adjusting for demographics, comorbidities, and other risk factors associated with cardiovascular disease (CVD).
A total of 296,041 BaS-cases and 2,004,804 obese control-cases were identified. Relative to controls, all baseline CVD risk factors were less common among BaS-cases. Nonetheless, even after adjusting for all CVD risk factors, controls exhibited marked increases in the odds of DHF overall (OR=2.80; 95% CI=2.52-3.10), and strongly-significant increases of 180%(OR=2.80; 95% CI: 2.52-3.10), 422%(OR=5.22; CI: 4.41-6.17), and 167%(OR=2.67; 95% CI: 1.88-3.80) amongst patients with and without HTN and patients with CAD, respectively.
In this retrospective, case-control study of a large, representative national sample of severely-obese patients, BaS was found to be associated with significantly-reduced subsequent hospitalizations for DHF when adjusted for baseline CVD risk factors. It also reduced DHF incidence in high-risk patients with HTN and CAD.