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    Home > Biochemistry News > Biotechnology News > How important is it to prevent heart failure in people with type 2 diabetes? Milestone tests remind you of key goals

    How important is it to prevent heart failure in people with type 2 diabetes? Milestone tests remind you of key goals

    • Last Update: 2021-02-24
    • Source: Internet
    • Author: User
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    The Action for Health in Diabetes trial, which began in 2001, is an important milestone study to explore the impact of enhanced lifestyle interventions on cardiovascular risk in overweight diabetics.
    earlier this year, the trial published results on heart failure.
    recently, the study lead author interpreted the results on the official website of the American College of Cardiology (JACC) to explore the role of lifestyle management in heart failure risk control in diabetic patients.
    today's article, we share the key points.
    the Outlook AHEAD trial: Finding two key targets The randomized controlled trial was conducted in 52,145 patients with type 2 diabetes who were overweight.
    the study group received lifestyle interventions with the goal of reducing weight by at least 7 percent by controlling diet and exercising, and the control group received routine disease support and education.
    stopped when the medium follow-up period was 9.6 years.
    previous data showed that patients in the enhanced lifestyle intervention group had reduced their weight and waist circumference more, and their cardiopulmonary health and blood sugar control had improved even more.
    , however, there was little difference in the risk of atherosclerosis cardiovascular disease in the two groups, and the incidence of heart failure was similar.
    lifestyle interventions don't seem to show cardiovascular benefits? Potential explanations include a lack of sustained and adequate weight loss and improved cardiopulmonary function and blood pressure in patients in the intervention group during the trial.
    , the team conducted a further analysis based on changes in heart and lung function and body mass index (BMI) in these patients.
    this time, the watershed appeared.
    at the start of the study, poor cardiopulmonary function was an independent risk factor for heart failure.
    After adjusting for the effects of other traditional cardiovascular risk factors, the underlying cardiopulmonary function of these type 2 diabetics was closely related to the risk of heart failure (HFpEF) retention in type 2 diabetes: the risk of HFpEF was reduced by 40% and 77%, respectively, compared to those with moderate and best cardiopulmonary function compared to those with the least cardiopulmonary function.
    And as the trial progressed and was continuously evaluated, if cardiopulmonary function and BMI continued to improve for four years, the overall risk of heart failure was significantly reduced: for every 10% improvement in cardiopulmonary function, the risk of heart failure was reduced by 10%, and for every 10% reduction in BMI, the risk of heart failure was reduced by 20%.
    suggest that improving cardiopulmonary function and BMI may be key goals for adjusting lifestyle to prevent heart failure.
    Lifestyle Intervention Goals: Sustained and Significant Improvements Study authors Dr. Kershaw Patel and Dr. Ambarish Pandey of the University of Texas Southwestern Medical Center note that observing changes over four years shows protective effects that suggest that people with type 2 diabetes may need lasting lifestyle improvements to prevent heart failure.
    previous studies have found that two years of exercise can improve heart health, while short-term training has not shown significant benefits.
    , on the other hand, the "amount" of exercise and the "amount" of weight loss may also be important determining the protective effects of lifestyle interventions on the heart.
    This is supported by other previous studies, such as an analysis that showed a dose-response relationship between exercise and heart failure risk, which was more closely associated with HFpEF, and, on the other hand, that moderate-intensity weight loss interventions, such as the weight-loss drug lorcaserin, had no effect on heart failure risk in clinical trials.
    , bariatric surgery can help patients lose significant and sustained weight, while the risk of cardiovascular disease, especially heart failure, is significantly reduced.
    , the authors' team found a significant correlation between cardiopulmonary health and a significant reduction in the risk of heart failure, particularly HFpEF, in people with diabetes.
    in the Look AHEAD trial, although the ≥7% weight loss enhanced lifestyle intervention did not reduce the risk of heart failure, the four-year continuous improvement in cardiopulmonary function and BMI showed significant protective effects.
    for current clinical practice, assessing cardiopulmonary function may help identify people with type 2 diabetes who are at higher risk of heart failure and may benefit from cardiopulmonary function training and weight loss.
    the future, assessing greater cardiopulmonary health and losing more weight will help us better understand the preventive effects of lifestyle interventions on heart failure in overweight patients.
    References: ( 1 ) Ambarish Pandey, et al., (2020). 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. Circulation, DOI: [2] Prevention of Heart Failure in Type 2 Diabetes Mellitus – The Importance of Lifestyle. Retrieved November 2, 2020, from [3] Rawshani A, et al., (2019). Risk factors, mortality, and cardiovascular outcomes in patients with type 2 diabetes. N Engl J Med, DOI: 10.1056/NEJMoa1800256
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