Reduced Risk of Cardiovascular Diseases After Bariatric Surgery Based on the New Predicting Risk of Cardiovascular Disease EVENTs Equations

Background We applied the novel Predicting Risk of Cardiovascular Disease EVENTs equations to evaluate cardiovascular–kidney–metabolic (CKM) health and estimated cardiovascular disease (CVD) risk after bariatric surgery. Methods Among 7804 patients (aged 20–79 years) undergoing bariatric surgery at Vanderbilt University Medical Center during 1999 to 2022, CVD risk factors from before surgery to 2 years after surgery were extracted from electronic health records. The 10‐ and 30‐year risks of total CVD, atherosclerotic CVD, coronary heart disease, stroke, and heart failure (HF) were estimated for patients without CVD history at each time point (n=124–2910), using the social deprivation index–enhanced Predicting Risk of Cardiovascular Disease EVENTs equations. Paired t tests or McNemar tests were used to compare pre‐ with postsurgery CKM health and CVD risk. Two‐sample t tests were used to compare CVD risk reduction between patient subgroups. Results CKM health was significantly improved after surgery with lower systolic blood pressure, non–high‐density lipoprotein cholesterol, and diabetes prevalence, and higher high‐density lipoprotein and estimated glomerular filtration rate. The 10‐year risks of total CVD and its subtypes decreased by 21.7% to 56.3% at 1 year after surgery and by 14.6% to 46.5% at 2 years after surgery, with the largest reduction observed for HF. Younger age, White race, >30% weight loss, and diabetes history were associated with greater HF risk reductions. Similar results were found for the 30‐year CVD risk estimates. Conclusions Bariatric surgery significantly improves CKM health and reduces estimated CVD risk, particularly HF, by 47% to 56% within 1 to 2 years after surgery. HF risk reduction may vary by patient's demographics, weight loss, and disease history, which warrants further research.