Abstract
Introduction: The association between obesity and arterial stiffness is complex and has been reported to be modified by age, with a positive association in older adults and an inverse association in younger adults. Additionally, several diet and exercise-based programs have demonstrated conflicting results regarding changes in arterial stiffness before and after weight reduction. However, few have explored arterial stiffness outcomes in bariatric surgery patients. Objective: To characterize changes in arterial stiffness after bariatric surgery. Methods: In 72 morbidly obese patients, we evaluated two measures of arterial stiffness, cardio-ankle vascular index (CAVI) and heart-ankle pulse wave velocity (haPWV), ~1 month prior to and 6 and 12 months after bariatric surgery. Arterial stiffness measures were assessed twice at each visit and averages were reported. Paired t-tests were used to evaluate the significance of changes after bariatric surgery. Results: The mean age of our study sample was 44.5 years (SD 11.2), and 72.2% were female. Average BMI substantially decreased after bariatric surgery (from 47.1 to 34.8 kg/m 2 ). Similarly, systolic blood pressure declined after surgery (from a mean of 143.0 to 131.7 mmHg) whereas diastolic blood pressure did not significantly differ. Both arterial stiffness measures, CAVI and haPWV, were significantly elevated after bariatric surgery (Figure, p<0.001). CAVI increased from baseline by an average of 0.64 (95% confidence interval [CI]: 0.42-0.87) at 6-month follow-up and 0.80 (95% CI: 0.53-1.07) 1 year after surgery. A similar pattern was observed for haPWV. Conclusions: Despite favorable changes in body weight and blood pressure, arterial stiffness measures were elevated after bariatric surgery. Although this observation is in line with an inverse association between obesity and arterial stiffness in younger adults, future studies are necessary to explore the underlying mechanisms and clinical implications of increased arterial stiffness after bariatric surgery.
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