Evidence map›Paper›PMID 41430024›Full record

SynthesisObesity surgery2026

Effects of Bariatric Surgery on the Pharmacokinetics of Cardiovascular Drugs: A Systematic Review and Meta-Analysis.

Yasaman Zarinfar, Sahba Babaei, Mohammad Javad Majidzadeh, Zeinab Masoumipoya, Azin Gheymati, Vahid Eslami

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Obesity surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Yasaman ZarinfarSchool of Medicine, Shahid Beheshti University of Medical Science, Tehran, Islamic Republic of Iran. yasamanzarinfar@gmail.com.ORCID http://orcid.org/0000-0002-3559-6022
Sahba BabaeiDepartment of Medicine, Arak University of Medical Science, Arak, Islamic Republic of Iran.ORCID http://orcid.org/0009-0001-2002-1170
Mohammad Javad MajidzadehDepartment of Medicine, Arak University of Medical Science, Arak, Islamic Republic of Iran.ORCID http://orcid.org/0009-0009-9593-1839
Zeinab MasoumipoyaDepartment of Medicine, Arak University of Medical Science, Arak, Islamic Republic of Iran.ORCID http://orcid.org/0009-0004-7254-0046
Azin GheymatiTehran University of Medical Sciences, School of Pharmacy, Tehran, Islamic Republic of Iran.ORCID http://orcid.org/0000-0003-3641-3010
Vahid EslamiShahid Beheshti University of Medical Sciences, Cardiovascular Research Center, Shahid Modarres Hospital, Tehran, Islamic Republic of Iran. veslami59@gmail.com.ORCID http://orcid.org/0000-0002-4304-3997

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundObesity is a global health issue associated with increased cardiovascular risk. Bariatric surgery is the most effective long-term treatment for severe obesity, but it may alter drug pharmacokinetics, impacting the management of cardiovascular medications.

methodsA systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. Four databases (PubMed, Embase, Web of Science, Scopus) were searched for studies examining the pharmacokinetics of cardiovascular drugs before and after bariatric surgery. After duplicate removal, titles and abstracts were screened, followed by a full-text review with inclusion criteria of adult patients undergoing bariatric surgery who reported pharmacokinetic or pharmacodynamic outcomes for cardiovascular drugs. Meta-analysis was performed using a random-effects model in R (meta and metafor packages), with effect sizes and heterogeneity (I²) reported.

resultsFrom 817 identified records, 24 studies met the inclusion criteria, revealing that bariatric surgery has varied and drug-specific effects on the pharmacokinetics of cardiovascular medications. Among anticoagulants, systemic exposure of all of them did not significantly change. Rivaroxaban and apixaban pharmacokinetics remained largely unchanged, and warfarin dosing requirements slightly decreased. The impact of beta-blockers was highly dependent on the specific drug and formulation; peak concentrations (Cmax) of atenolol increased slightly, whereas those of immediate-release metoprolol tended to increase, but both types of carvedilols (S- and R-carvedilol) and controlled-release metoprolol and propranolol showed a decrease. Regarding statins, atorvastatin absorption was significantly delayed, as shown by a prolonged time to peak concentration Tmax​ (pooled SMD = 0.99, p < 0.05), without a significant change in Cmax​ (slightly decreased). Both rosuvastatin and simvastatin showed transient changes in exposure, which normalized over time.

conclusionBariatric surgery can significantly impact the pharmacokinetics of cardiovascular drugs, especially atorvastatin and beta-blockers, highlighting the need for individualized dose adjustments and therapeutic monitoring. These findings provide essential evidence for optimizing cardiovascular pharmacotherapy in post-bariatric surgery patients, supporting the development of tailored dosing guidelines.

Indexed as

Bariatric SurgeryCardiovascular AgentsCardiovascular DiseasesObesity, MorbidHumansCardiovascular AgentsBariatric surgeryCardiovascular drugsDrug absorptionMeta-analysisPharmacokinetics

Identifiers

PMID41430024

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.