Association of Intensive Lifestyle Intervention, Fitness, and Body Mass Index With Risk of Heart Failure in Overweight or Obese Adults With Type 2 Diabetes Mellitus: An Analysis From the Look AHEAD Trial
Primary result · Incident HFResult — go to the resultHazard ratio 0.96 95% CI 0.75–1.23Authors' conclusion
Among participants with type 2 diabetes mellitus in the Look AHEAD trial, the intensive lifestyle intervention did not appear to modify the risk of HF. Higher baseline CRF and sustained improvements in CRF and weight loss were associated with lower risk of HF.
Study context
- Population
- Overweight or obese adults with T2DM without prevalent heart failure (HF) (Look AHEAD trial)257 incident HF
- Participants
- 5,109 participants
- Comparison
- Intensive lifestyle intervention vs diabetes support and education; and cardiorespiratory fitness (CRF) and BMI with risk of HF
- Primary endpoint
- Incident HF
- Follow-up
- Median 12.4 years
Primary result
As reported in the abstract
Hazard ratio
0.96
95% CI 0.75–1.23
Intensive lifestyle interventionvs Diabetes support and education
HR 0.96 (95% CI 0.75–1.23)
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| Incident HF by baseline CRF tertileModerate fit (tertile 2)vs Low fit (tertile 1)39% lower risk · most adjusted Cox models | 0.61 (0.44–0.83) | |
| Incident HF by baseline CRF tertileHigh fit (tertile 3)vs Low fit (tertile 1)62% lower risk · most adjusted Cox models | 0.38 (0.24–0.59) | |
| Changes in CRF and BMI and HF (repeat CRF assessments, n=3902) · 4-year follow-upPer 10% increase in CRF | 0.90 (0.82–0.99) | |
| Changes in CRF and BMI and HF (repeat CRF assessments, n=3902) · 4-year follow-upPer 10% decrease in BMI | 0.80 (0.69–0.94) | |
| 0.20.5125Hazard ratio (log scale) |
HFrEF and HFpEF by baseline CRF
- HFpEF risk lower in moderate fit group
- 40%
- HFpEF risk lower in high fit group
- 77%
- Baseline CRF not significantly associated with incident HFrEF
- Adjusted for traditional CV risk factors and interval MI
Baseline BMI and HF, HFpEF, HFrEF
- Baseline BMI not associated with incident HF, HFpEF or HFrEF
- Adjusted for CRF and traditional CV risk factors
Original publication
Association of Intensive Lifestyle Intervention, Fitness, and Body Mass Index With Risk of Heart Failure in Overweight or Obese Adults With Type 2 Diabetes Mellitus: An Analysis From the Look AHEAD Trial. Circulation. Published 5 March 2020. doi:10.
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