Bariatric surgery reduces cardiac risks and mortality in obese patients with sleep apnea

Bariatric surgery reduces cardiac risks and mortality in obese patients with sleep apnea,heart attack, stroke, and atrial fibrillation in patients with moderate to severe obstructive sleep apnea (OSA), according to a new study from Cleveland Clinic and presented here today at the American Society for Metabolic and Bariatric Surgery (ASMBS) 2023 Annual Scientific Meeting. Researchers also report metabolic surgery patients cut their risk of death by nearly 40%.

OSA is a dangerous sleep disorder that affects nearly 1 billion adults worldwide -- about 70% also have obesity. Obesity can cause excess fat to deposit around the upper airway, which can compress the upper airways and interfere with breathing during sleep. Standard treatment is with continuous positive airway pressure (CPAP), but the therapy only addresses symptoms, is not curative and does not reduce the risk of MACE or death, which has a high incidence among patients with OSA.

In the cohort study of 13,657 Cleveland Clinic patients with a diagnosis of obesity and moderate to severe OSA, 970 patients had gastric bypass or sleeve gastrectomy while 12,687 matched patients received CPAP or usual non-surgical care between 2004 and 2018. Patients were followed until September 2022 for MACE, a composite of all-cause death or cardiovascular disease.

After 10 years, MACE occurred in 27% of patients in the bariatric surgery group compared to 35.6% in the nonsurgical group. All-cause mortality was also 37% less for bariatric surgery patients (9.1% vs. 12.5%) who maintained about a 25% weight loss compared to the under 5% weight loss in the non-surgical group

Reference: Ali Aminian et al, AMERICAN SOCIETY FOR METABOLIC AND BARIATRIC SURGERY