HJAR Sep/Oct 2022

54 SEP / OCT 2022 I  HEALTHCARE JOURNAL OF ARKANSAS BARIATRIC COLUMN BARIATRIC WITHNEARLY 700,000 deaths annually, the Centers for Disease Control and Prevention (CDC) reports heart disease as the leading cause of death in the United States. And ac- cording to the World Health Organization, the leading cause of death in the world is also heart disease, which accounts for nearly 16% of deaths worldwide. Unsurprisingly, it is also the leading cause of death forArkansans, and currently our state ranks fourth in the nation for cardiovascular mortality rates. The loss of life alone is enough to warrant an aggressive response from policymakers on both the state and national levels. But the economic impact is also sobering. The CDC reports cardiovascular disease costs the United States in excess of $200 billion annu- ally. Some projections indicate the cost of cardiovascular disease will exceed $1 trillion BARIATRICSURGERY Reduces the Risk for Cardiovascular Death by 2035. This staggering economic impact is due to direct medical costs as well as the downstream effects of lost productivity, dis- ability, presenteeism, and associated care- giver losses. The risk factors for cardiovascular dis- ease are numerous. Some are considered non-modifiable because the patient cannot do anything to adjust the risk. These non- modifiable risk factors include age, family history, and gender to name a few. But some of the cardiovascular disease risk factors are considered modifiable since the patient can take steps to diminish the risk. The most cited modifiable risk factors include high blood pressure, high cholesterol, diabetes, and obesity. It’s no wonder bariatric surgery has been shown to increase life expectancy by five to 10 years when one compares the list of modi- fiable cardiac risk factors to a list of diseases improved by bariatric surgery. Bariatric sur- gery has a dramatic impact on the modifiable cardiovascular disease risk factors. Obesity in particular responds extraordinarily well to bariatric surgery, with patients losing be- tween 50% and 80% of their excess body weight on average. This improvement helps mitigate the long-term damage of obesity on the heart, which results in a longer and better life for the patient. Obesity is a well-known risk factor for car- diovascular disease. In 1999, Eugenia Calle, PhD, published an article in the NewEngland Journal of Medicine in which she and fellow researchers followed over 1 million people prospectively for nearly 15 years. The risk of death due to cardiovascular disease increased