Although a favorable reduction in proatherogenic metabolic profiles occurs within weeks to months, long-term data from the Swedish Obese Subjects (SOS) study demonstrate substantial and sustained benefit, with >10-year rates of recovery from diabetes, sleep apnea, hypertension, hypertriglyceridemia, and hyperuricemia after bariatric surgery, which is remarkable. Importantly, these alterations are associated with reduced risk of myocardial infarction and prolonged cardiovascular survival.18 In addition to improving metabolic dysfunction, weight reduction is associated with decreases in circulating cytokines such as interleukin 6, tumor necrosis factor-α, and C-reactive protein and upregulation of vasculoprotective factors such as adiponectin. Beneficial physiological and structural changes also become manifest with weight loss. For example, our group has shown that vascular endothelial function improves significantly within 3 months after bariatric surgery and is sustained at 12 months.19,20 Cardiac geometry and myocardial performance also improve after weight intervention.
