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Impact of weight loss on ankle‐brachial index and interartery blood pressures
Author(s) -
Espeland Mark A.,
Lewis Cora E.,
Bahnson Judy,
Knowler William C.,
Regensteiner Judith G.,
Gaussoin Sarah A.,
Beavers Daniel,
Johnson Karen C.
Publication year - 2014
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.20658
Subject(s) - medicine , blood pressure , ankle , overweight , weight loss , diabetes mellitus , randomized controlled trial , brachial artery , cardiology , obesity , type 2 diabetes , surgery , endocrinology
Objective To assess whether weight loss improves markers of peripheral artery disease and vascular stenosis. Methods The Action for Health in Diabetes randomized clinical trial compared intensive lifestyle intervention (ILI) for weight loss to a control condition of diabetes support and education (DSE) in overweight or obese adults with type 2 diabetes. Annual ankle and brachial blood pressures over four years were used to compute ankle‐brachial indices (ABIs) and to assess interartery blood pressure differences in 5018 participants. Results ILI, compared to DSE, produced 7.8% (Year 1) to 3.6% (Year 4) greater weight losses. These did not affect prevalence of low (<0.90) ABI (3.60% in DSE versus 3.14% in ILI; P = 0.20) or elevated (>1.40) ABI (7.52% in DSE versus 7.59% in ILI: P = 0.90), but produced smaller mean (SE) maximum interartery systolic blood pressure differences among ankle sites [19.7 (0.2) mmHg for ILI versus 20.6 (0.2) mmHg for DSE ( P < 0.001)] and between arms [5.8 (0.1) mmHg for ILI versus 6.1 (0.1) mmHg for DSE ( P = 0.01)]. Conclusions Four years of intensive behavioral weight loss intervention did not significantly alter prevalence of abnormal ABI, however, it did reduce differences in systolic blood pressures among arterial sites.