title: Impact of weight loss on ankle-brachial index and interartery blood pressures.
abstract: 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.
authors.affiliation: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Espeland
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: Judy
authors.initials: J
authors.lastname: Bahnson
authors.forename: William C
authors.initials: WC
authors.lastname: Knowler
authors.forename: Judith G
authors.initials: JG
authors.lastname: Regensteiner
authors.forename: Sarah A
authors.initials: SA
authors.lastname: Gaussoin
authors.forename: Daniel
authors.initials: D
authors.lastname: Beavers
authors.forename: Karen C
authors.initials: KC
authors.lastname: Johnson
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001521:Behavior Therapy; D001794:Blood Pressure / Q000502:physiology*; D016893:Carotid Stenosis / Q000453:epidemiology; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D058729:Peripheral Arterial Disease / Q000453:epidemiology; D012307:Risk Factors; D015431:Weight Loss / Q000502:physiology*