IMPACT OF BARIATRIC SURGERY ON CARDIOVASCULAR RISK FACTORS: A NARRATIVE REVIEW

Obesity can be considered a global pandemic, already affecting a considerable and increasing number of adults. It has been described as one of the most important preventable causes of cardiovascular morbidity and mortality. Obesity accelerates the development and progression of cardiovascular disease through its strong correlations with hypertension, dyslipidemia, insulin resistance, type 2 diabetes mellitus, systemic inflammation, and adverse cardiac remodeling. Bariatric surgery, the current most effective long-term treatment for obesity, has increasingly been recognized as a metabolic intervention with benefits to the cardiovascular system. Accumulating evidence indicates that surgical weight loss is accompanied by rapid and sustained improvements in glycemic control, with high rates of diabetes remission, significant reductions in blood pressure, and favorable changes in lipid profiles. In parallel, bariatric procedures lead to attenuation of chronic low-grade inflammation, improvement in endothelial function, and regression of obesity-related cardiac structural abnormalities. Studies demonstrate a substantial reduction in major adverse cardiovascular events and cardiovascular mortality among surgically treated patients compared with matched nonsurgical controls. These benefits may result from both weight-dependent and weight-independent mechanisms, including alterations in gut hormones, bile acid metabolism, insulin sensitivity, and neurohormonal regulation. This narrative review aims to present the current evidence on the effects of bariatric surgery on established cardiovascular risk factors, discuss potential mechanistic pathways, types of bariatric procedures and emphasize the role of metabolic surgery as an effective strategy for reducing cardiovascular risk in individuals with obesity.