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

Citation
Brinkley, T. E., et al. “Long-Term Effects Of An Intensive Lifestyle Intervention On Electrocardiographic Criteria For Left Ventricular Hypertrophy: The Look Ahead Trial.”. American Journal Of Hypertension, pp. 541-548.
Center Joslin Diabetes Center University of Washington
Multicenter
Multicenter
Author Tina E Brinkley, Andrea Anderson, Elsayed Z Soliman, Alain G Bertoni, Frank Greenway, William C Knowler, Stephen P Glasser, Edward S Horton, Mark A Espeland, Look AHEAD Research Group
Abstract

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 × time interaction, P = 0.49). Increases in Cornell voltage during follow-up were also similar between intervention groups (group × 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.

CLINICAL TRIALS REGISTRATION: Trial Number NCT00017953 (ClinicalTrials.gov).

Year of Publication
2018
Journal
American journal of hypertension
Volume
31
Issue
5
Number of Pages
541-548
Date Published
12/2018
ISSN Number
1941-7225
DOI
10.1093/ajh/hpy004
Alternate Journal
Am. J. Hypertens.
PMID
29324968
PMCID
PMC6074947
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