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Member Research and Reports

Member Research and Reports

UAB: History of Cardiovascular Disease, Intensive Lifestyle Intervention, and Cardiovascular Outcomes in the Look AHEAD Trial

Lifestyle interventions have been shown to reduce cardiovascular disease (CVD) risk factors and have other health benefits for individuals with overweight or obesity and type 2 diabetes. However, there are few data on long-term effects of lifestyle intervention on CVD morbidity or mortality. The Action for Health in Diabetes (Look AHEAD) trial randomized volunteers with type 2 diabetes to either an intensive lifestyle intervention (ILI) or diabetes support and education (DSE), the usual‐care control condition.

A team of researchers collaborated on this study, including Dr. Cora Elizabeth (Beth) Lewis and Dr. Stephen P. Glasser, Department of Epidemiology, University of Alabama at Birmingham School of Public Health.

This study conducted post hoc analyses of the rates of the primary composite outcome and components, adjudicated cardiovascular death, nonfatal myocardial infarction (MI), stroke, and hospitalization for angina, as well as three secondary composite cardiovascular outcomes.

Although the overall Look AHEAD results did not show differences in CVD rates by randomized treatment group, there was a suggestion of heterogeneity in response to ILI by the baseline history of CVD, specifically for nonfatal myocardial infarction (MI). The findings nonetheless have implications for a clinical trial design because trials generally assume homogeneous results among subgroups. Investigators may wish to consider this potential heterogeneity of response when designing CVD‐outcome trials.

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