Key result
Bariatric surgery with ≥25% weight loss is linked to a ~13 mmHg systolic drop and increased intracranial velocity.
Why the study?
The relationship of obesity with small vessel disease remains controversial.
Does bariatric surgery with significant weight loss improve cerebral hemodynamic parameters in obese patients without cardiovascular disease?
Observational (n=18)
Does bariatric surgery with significant weight loss improve cerebral hemodynamic parameters in obese patients without cardiovascular disease?
Significant weight loss (≥25%) following bariatric surgery in obese patients is associated with lower systolic blood pressure and improved intracranial hemodynamic parameters.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for hemodynamic benefits of bariatric surgery in obese patients; leaves open small vessel disease implications pending RCTs.
Background and aims The relationship of obesity with small vessel disease remains controversial. The HemOb study aims to evaluate hemodynamic and functional parameters in patients with obesity undergoing bariatric surgery and achieving significant weight loss. Methods Twenty free-of-cardiovascular-disease-patients with indication for bariatric surgery accepted to participate and signed informed consent (after ethics committee approval). Each participant was assessed twice: just before surgery; and as soon as possible once they had lost at least 25% of their initial weight. We gather and compare clinical data (age, sex, cardiovascular risk factors and medications), anthropometric data (weight, height, BMI and waist circumference) and systemic and cerebral hemodynamic data (basal arterial pressure, ankle-brachial index, endothelium-dependent vasodilation in braquial artery, carotid IMT and atheromatous plaques; and speedometers of extracranial and proximal segments of intracranial arteries using ultrasonography). Results Two patients were finally excluded (one lost-to-follow-up, one unable to achieve target weight). The mean age was 44±8.3 years and 61% were women. The mean weight lost was 43 ±15Kg, and the mean IMC difference was 14.7±5. Compared to themselves preintervention (Pre), participants postintervention (Post) show lower systolic arterial pressure (Pre136±11.4 vs Post122.9±13.1 mmHg; p0.002); higher peak systolic velocity in intracranial ICA (Pre70.8±18.5 vs Post85.7±13.9 cm/sec; p0.03) and MCA (Pre83.9±25.6 vs Post97.7±18.1 cm/sec; p0.01). Anchial-brachial index and endothelium-dependent vasodilation show non-significant improvements. Conclusions Obese patients losing at least 25% of their original weight show significant changes in key intracranial hemodynamic parameters, linked to systolic blood pressure lowering.
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Moraleda et al. (2026) conducted an observational in Obesity (n=18). Bariatric surgery with ≥25% weight loss vs. Pre-intervention baseline was evaluated on Hemodynamic and functional parameters (systolic arterial pressure, peak systolic velocity in intracranial ICA and MCA). Bariatric surgery with ≥25% weight loss significantly lowered systolic arterial pressure (136 vs 122.9 mmHg, p=0.002) and increased peak systolic velocity in intracranial ICA (p=0.03) and MCA (p=0.01).
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