Long-Term Effects of an Intensive Lifestyle Intervention on Electrocardiographic Criteria for Left Ventricular Hypertrophy: The Look AHEAD Trial

被引:8
作者
Brinkley, Tina E. [1 ]
Anderson, Andrea [2 ]
Soliman, Elsayed Z. [3 ]
Bertoni, Alain G. [3 ]
Greenway, Frank [4 ]
Knowler, William C. [5 ]
Glasser, Stephen P. [6 ]
Horton, Edward S. [7 ]
Espeland, Mark A. [2 ]
机构
[1] Wake Forest Sch Med, Sect Gerontol & Geriatr Med, Dept Internal Med, Winston Salem, NC 27101 USA
[2] Wake Forest Sch Med, Dept Biostat Sci, Winston Salem, NC USA
[3] Wake Forest Sch Med, Dept Epidemiol & Prevent, Winston Salem, NC USA
[4] Louisiana State Univ Syst, Pennington Biomed Res Ctr, Baton Rouge, LA USA
[5] NIDDK, Diabet Epidemiol & Clin Res Sect, NIH, Phoenix, AZ USA
[6] Univ Alabama Birmingham, Div Prevent Med, Birmingham, AL USA
[7] Harvard Med Sch, Joslin Diabet Ctr, Boston, MA USA
关键词
blood pressure; diabetes; electrocardiography; exercise; hypertension; left ventricular hypertrophy; obesity; weight loss; AMERICAN-HEART-ASSOCIATION; BODY-MASS INDEX; WEIGHT-LOSS; DIABETES-MELLITUS; CARDIOVASCULAR-DISEASE; SCIENTIFIC STATEMENT; ATHEROSCLEROSIS MESA; MAGNETIC-RESONANCE; GENERAL-POPULATION; ETHNIC-DIFFERENCES;
D O I
10.1093/ajh/hpy004
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
BACKGROUND Left ventricular hypertrophy assessed by electrocardiography (ECG-LVH) is a marker of subclinical cardiac damage and a strong predictor of cardiovascular disease (CVD) events. The prevalence of ECG-LVH is increased in obesity and type 2 diabetes; however, there are no data on the long-term effects of weight loss on ECG-LVH. The purpose of this study was to determine whether an intensive lifestyle intervention (ILI) reduces ECG-LVH in overweight and obese adults with type 2 diabetes. METHODS Data from 4,790 Look AHEAD participants (mean age: 58.8 +/- 6.8 years, 63.2% White) who were randomized to a 10-year ILI (n = 2,406) or diabetes support and education (DSE, n = 2,384) were included. ECG-LVH defined by Cornell voltage criteria was assessed every 2 years. Longitudinal logistic regression analysis with generalized estimation equations and linear mixed models were used to compare the prevalence of ECG-LVH and changes in absolute Cornell voltage over time between intervention groups, with tests of interactions by sex, race/ethnicity, and baseline CVD status. RESULTS The prevalence of ECG-LVH at baseline was 5.2% in the DSE group and 5.0% in the ILI group (P = 0.74). Over a median 9.5 years of follow-up, prevalent ECG-LVH increased similarly in both groups (odds ratio: 1.02, 95% confidence interval: 0.83-1.25; group x time interaction, P = 0.49). Increases in Cornell voltage during follow-up were also similar between intervention groups (group x time interaction, P = 0.57). Intervention effects were generally similar between subgroups of interest. CONCLUSIONS The Look AHEAD long-term lifestyle intervention does not significantly lower ECG-LVH in overweight and obese adults with type 2 diabetes.
引用
收藏
页码:541 / 548
页数:8
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