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Impact of weight loss on ankle-brachial index and interartery blood pressures
Espeland MA, Lewis CE, Bahnson J, Knowler WC, Regensteiner JG, Gaussoin SA, Beavers D, Johnson KC, Look AHEAD Research Group
Obesity 2014 Apr;22(4):1032-1041
clinical trial
6/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

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 5,018 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.

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