Cardiovascular Risk Factors Following Vertical Sleeve Gastrectomy in Black Americans Compared with White Americans
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Cardiovascular Risk Factors Following Vertical Sleeve Gastrectomy in Black Americans Compared with White Americans Joshua S. Speed 1 & William A. Pruett 1 & Seth T. Lirette 2 & Joseph J. Cook 1 & Charles L. Phillips 3 & Bernadette E. Grayson 3 Received: 12 March 2020 / Revised: 16 August 2020 / Accepted: 17 August 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Objective Bariatric surgery presents a long-term solution for clinical obesity. Given that Black Americans (BA) carry a greater burden of obesity-related comorbidities than White Americans (WA), understanding the racial disparities regarding remission of obesity comorbidities following the most common bariatric surgery, sleeve gastrectomy (SG). The goal of the current study was to provide quantitative values related to cardiovascular and lipid outcomes following SG and determine if racial disparities exist between BA and WA. Methods Data was collected from de-identified electronic medical records for patients receiving SG surgery at the University of Mississippi Medical Center in Jackson, MS, USA. Results Of 464 patients who obtained SG from (2013–2019), 64% were WA, and 36% were BA. Before surgery, BA had significantly greater body weight (BW), body mass index (BMI), and systolic (SBP) and diastolic (DBP) blood pressures (BP) in comparison with WA. Compared with WA, BA were predicted to lose 5.1 kg less BW than WA at 1-year follow-up. Reduction in SBP (− 0.96 vs. − 0.60 mmHg/doubling of days) and DBP (− 0.51 vs. − 0.26 mmHg/doubling of days) was significantly higher in WA compared with BA. There was no racial difference in the change to total cholesterol, high-density lipoprotein (HDL)cholesterol, low-density lipoprotein (LDL)-cholesterol, or triglycerides by race. When normalized to weight loss, the racial disparity in BP reduction was mitigated. Conclusions These data indicate that BA lose less body weight following SG; however, loss of excess body weight loss is associated with improvement to BP similarly in both BA and WA. Keywords Bariatric surgery . Blood pressure . Cardiovascular risk . Lipids
Introduction According to the National Health and Nutrition Examination Survey from 2017 to 2018, obesity and its various comorbidities affect over 40% of the US population. For obesity treatment, surgical weight loss is the most successful strategy to reduce the burden of excess body weight, diabetes, dyslipidemia, and * Joshua S. Speed [email protected] 1
Department of Physiology and Biophysics, University of Mississippi Medical Center, 2500 North State St. Guyton 558, Jackson, MS 39216, USA
2
Department of Data Science, University of Mississippi Medical Center, Jackson, MS 39216, USA
3
Department of Neurobiology and Anatomical Sciences, University of Mississippi Medical Center, Jackson, MS 39216, USA
hypertension [1]. Although more than 250,000 individuals undergo surgical weight loss procedures per year in the USA alone [2], the underpinnings of the mechanisms of action to produce positive bene
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