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.

Figure 1

Figure 1a: Mean maximum absolute pairwise difference among systolic blood pressure measurements taken on four ankle arteries: right and left tibia versus dorsal pedis arteries (with adjustment for baseline absolute difference). Figure 1b: Mean absolute difference between systolic blood pressures in the left and right arms (with adjustment for baseline absolute difference).

Figure 1

Figure 1a: Mean maximum absolute pairwise difference among systolic blood pressure measurements taken on four ankle arteries: right and left tibia versus dorsal pedis arteries (with adjustment for baseline absolute difference). Figure 1b: Mean absolute difference between systolic blood pressures in the left and right arms (with adjustment for baseline absolute difference).