{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T13:52:53Z","timestamp":1762005173476,"version":"3.40.5"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T00:00:00Z","timestamp":1578009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000096","name":"National Center on Minority Health and Health Disparities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000096","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000030","name":"Centers for Disease Control and Prevention","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000030","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000124","name":"Office of Research on Women's Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000124","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000056","name":"National Institute of Nursing Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000056","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004851","name":"New York City Department of Health and Mental Hygiene","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004851","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Obesity"],"published-print":{"date-parts":[[2020,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine the effects of an intensive lifestyle intervention (ILI) on cardiovascular disease (CVD), the Action for Health in Diabetes (Look AHEAD) trial randomized 5,145 participants with type 2 diabetes and overweight\/obesity to a ILI or diabetes support and education. Although the primary outcome did not differ between the groups, there was suggestive evidence of heterogeneity for prespecified baseline CVD history subgroups (interaction <jats:italic>P<\/jats:italic>\u2009=\u20090.063). Event rates were higher in the ILI group among those with a CVD history (hazard ratio 1.13 [95% CI: 0.90\u20101.41]) and lower among those without CVD (hazard ratio 0.86 [95% CI: 0.72\u20101.02]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Interaction <jats:italic>P<\/jats:italic> values for the primary and two secondary composites were similar (0.060\u20100.064). Of components, the interaction was significant for nonfatal MI (<jats:italic>P<\/jats:italic>\u2009=\u20090.035). This interaction was not due to confounding by baseline variables, different intervention responses for weight loss and physical fitness, or hypoglycemic events. In those with a CVD history, statin use was high and similar by group. In those without a CVD history, low\u2010density lipoprotein cholesterol levels were higher (<jats:italic>P<\/jats:italic>\u2009=\u20090.003) and statin use was lower (<jats:italic>P<\/jats:italic>\u2009\u2264\u20090.001) in the ILI group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Intervention response heterogeneity was significant for nonfatal MI. Response heterogeneity may need consideration in a CVD\u2010outcome trial design.<\/jats:p><\/jats:sec>","DOI":"10.1002\/oby.22676","type":"journal-article","created":{"date-parts":[[2020,1,3]],"date-time":"2020-01-03T10:35:40Z","timestamp":1578047740000},"page":"247-258","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["History of Cardiovascular Disease, Intensive Lifestyle Intervention, and Cardiovascular Outcomes in the Look AHEAD Trial"],"prefix":"10.1002","volume":"28","author":[{"name":"Look AHEAD Research Group","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2301-5796","authenticated-orcid":false,"given":"Cora E.","family":"Lewis","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Bantle","sequence":"additional","affiliation":[{"name":"University of Minnesota Minneapolis Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alain G.","family":"Bertoni","sequence":"additional","affiliation":[{"name":"Wake Forest University Winston\u2010Salem North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Blackburn","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Frederick L.","family":"Brancati","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George A.","family":"Bray","sequence":"additional","affiliation":[{"name":"Pennington Biomedical Research Center Baton Rouge Louisiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lawrence J.","family":"Cheskin","sequence":"additional","affiliation":[{"name":"Johns Hopkins University Baltimore Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey M.","family":"Curtis","sequence":"additional","affiliation":[{"name":"Southwestern American Indian Center National Institute of Diabetes and Digestive and Kidney Diseases and St. Joseph\u2019s Hospital and Medical Center Phoenix Arizona USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caitlin","family":"Egan","sequence":"additional","affiliation":[{"name":"The Miriam Hospital Brown Medical School Providence Rhode Island USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary","family":"Evans","sequence":"additional","affiliation":[{"name":"National Institute of Diabetes and Digestive and Kidney Diseases Bethesda Maryland USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John P.","family":"Foreyt","sequence":"additional","affiliation":[{"name":"Baylor College of Medicine Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siran","family":"Ghazarian","sequence":"additional","affiliation":[{"name":"University of Southern California Los Angeles California USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bethany","family":"Barone Gibbs","sequence":"additional","affiliation":[{"name":"University of Pittsburgh Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen P.","family":"Glasser","sequence":"additional","affiliation":[{"name":"University of Alabama at Birmingham Birmingham Alabama USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"W. 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