Body mass index, exercise capacity and functional status in chronic heart failure.

Aims: This short communication aims to assess the associations of body mass index (BMI) with key functional parameters, including exercise tolerance and functional status, among individuals with chronic heart failure.

Methods And Results: From four chronic heart failure studies ( HF-ACTION [Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training], NEAT-HFpEF [Nitrate's Effect on Activity Tolerance in Heart Failure With Preserved Ejection Fraction (HFpEF)], INDIE-HFpEF [Inorganic Nitrite Delivery to Improve Exercise Capacity in HFpEF], and RELAX-HFpEF [Phosphodiesterase-5 Inhibition to Improve Clinical Status and Exercise Capacity in Heart Failure with Preserved Ejection Fraction]), we studied 2,546 participants (mean age: 60.2 ± 12.

Estimated Glomerular Filtration Rate Variability and Incident Heart Failure in Adults With Type 2 Diabetes.

Background: Variability in kidney function, as measured by estimated glomerular filtration rate (eGFR), has been proposed as a novel risk factor for adverse cardiovascular outcomes. However, its association with incident heart failure (HF) in adults with type 2 diabetes remains unclear.

Objectives: The aim of the study was to evaluate the association of eGFR variability with incident HF in a large sample of adults with type 2 diabetes.

Visit-to-Visit Variability in Lipid Levels and Risk of Incident Heart Failure in Adults With Type 2 Diabetes.

Objective: Limited data exist on the relation between long-term variability in blood lipid fractions and incident heart failure (HF) in the setting of type 2 diabetes mellitus (T2DM).

Research Design And Methods: Among 9,443 participants with T2DM from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, with lipid measurements available at six time points (baseline, 4, 8, 12, 24, and 36 months), we assessed variability in total cholesterol (TC), LDL cholesterol, HDL cholesterol, and triglycerides (TG) across visits, using coefficient of variation (CV), SD, and variability independent of the mean. Cox proportional hazards models were employed to estimate adjusted hazard ratios (HRs) for incident HF.

Diabetes, Subclinical Myocardial Injury or Stress, and Risk of Heart Failure Subtypes: The Jackson Heart Study.

Objective: To assess the extent to which the concomitant presence of subclinical myocardial injury or stress and diabetes affects the risk of heart failure (HF) subtypes.

Research Design And Methods: The Jackson Heart Study included Black adults, categorized based on diabetes status, high-sensitivity cardiac troponin I (hs-cTnI), and brain natriuretic peptide (BNP) levels. Subclinical myocardial injury was defined as hs-cTnI ≥4 ng/L in women and ≥6 ng/L in men, and subclinical myocardial stress as BNP ≥35 pg/mL.

Association Between Microvascular Disease and Cardiorespiratory Fitness Among Adults With Type 2 Diabetes.

Objective: Little is known about the extent to which microvascular disease is associated with cardiorespiratory fitness (CRF) among individuals with type 2 diabetes.

Research Design And Methods: A total of 4,766 participants with type 2 diabetes underwent maximal exercise testing in the Look AHEAD (Action for Health in Diabetes) study at baseline. Low CRF was defined based on the Aerobics Center Longitudinal Study reference standards.

Association between weight variability, weight change and clinical outcomes in hypertension.

Objective: The effect of body weight variability (BWV) and body weight change (BWC) in high-risk individuals with hypertension, but without diabetes mellitus (DM) remains unclear. We examined the effect of BWV and BWC on the primary outcome [the composite of myocardial infarction (MI), other acute coronary syndromes, stroke, acute decompensated heart failure (HF), or cardiovascular (CV) death] and all-cause mortality in the Systolic Blood Pressure Intervention Trial (SPRINT).

Methods: In this post-hoc analysis, we used multivariate Cox regression models to examine the risk associated with BWV and BWC for the primary outcome in SPRINT.

Cardiac Autonomic Dysfunction and Risk of Silent Myocardial Infarction Among Adults With Type 2 Diabetes.

Background There is a paucity of large-scale epidemiological studies on the link between cardiac autonomic neuropathy (CAN) and the risk of silent myocardial infarction (SMI) in type 2 diabetes. We evaluated the association between CAN and the risk of SMI in a large sample of adults with type 2 diabetes. Methods and Results Participants with type 2 diabetes from the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study without atherosclerotic cardiovascular disease at baseline were included.

Association between physical activity and clinical outcomes in high-risk hypertension: Post-hoc analysis of SPRINT.

Objective: Engaging in physical activity (PA) is recommended to reduce the risk of morbidity and mortality in patients with hypertension. However, the association between PA and clinical outcomes in individuals with high-risk hypertension is understudied. We examined the relationship between PA and clinical outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT).

Blood Pressure Variability and Risk of Atrial Fibrillation in Adults With Type 2 Diabetes.

Background: There is a paucity of epidemiological data on the association between long-term variability of blood pressure (BP) and incident atrial fibrillation (AF).

Objectives: The purpose of this study was to evaluate the association of BP variability with incident AF in a large sample of adults with type 2 diabetes.

Methods: We included participants who had ≥5 BP measurements in the first 24 months of action to control cardiovascular risk in diabetes.

Safety of SGLT2i with regard to bone and mineral metabolism in patients with CKD.

Purpose Of Review: Sodium-glucose cotransporter 2 inhibitors (SGLT2i) represent a relatively new class of oral glucose-lowering agents that reduce adverse cardiovascular and kidney outcomes among individuals with chronic kidney disease (CKD). Emerging evidence suggests that SGLT2i may also affect bone and mineral metabolism. This review analyzes recent evidence on the safety of SGLT2i with respect to bone and mineral metabolism in people with CKD, and discusses potential underlying mechanisms and clinical implications.

Cardiac autonomic dysfunction and risk of incident stroke among adults with type 2 diabetes.

Introduction: There is a dearth of data on the association between cardiac autonomic neuropathy (CAN) with incident stroke among individuals with diabetes mellitus. We evaluated this association in a large sample of adults with type 2 diabetes.

Patients And Methods: Participants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study without atherosclerotic cardiovascular disease at baseline were included.

Autonomic dysfunction and risk of severe hypoglycemia among individuals with type 2 diabetes.

There are limited data on the link between cardiac autonomic neuropathy (CAN) and severe hypoglycemia in type 2 diabetes. Here, we evaluated the associations of CAN with severe hypoglycemia among 7,421 adults with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes study. CAN was defined using ECG-derived measures.

Burden of Microvascular Disease and Risk of Atrial Fibrillation in Adults with Type 2 Diabetes.

Background: Epidemiological data on the associations of microvascular disease with atrial fibrillation are scarce. We evaluated the associations of diabetes-related microvascular disease in multiple vascular beds and its burden with incident atrial fibrillation among adults with type 2 diabetes.

Methods: A total of 7603 participants with type 2 diabetes and without atrial fibrillation were assessed for diabetic kidney disease, retinopathy, or neuropathy at baseline in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.

Association of heart rate variability with progression of retinopathy among adults with type 2 diabetes.

Aim: We evaluated the associations of heart rate variability (HRV) with incident vision-threatening retinopathy and retinopathy progression among adults with type 2 diabetes.

Methods: Participants recruited to the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study with HRV measures at baseline were analysed. HRV measures included standard deviation of all normal-to-normal intervals (SDNN) and root mean square of successive differences between normal-to-normal intervals (rMSSD).

Severe Hypoglycemia and Incidence of QT Interval Prolongation Among Adults With Type 2 Diabetes.

Context: There is a paucity of large-scale epidemiological studies on the link between severe hypoglycemia (SH) and corrected QT (QTc) interval prolongation in type 2 diabetes (T2DM).

Objective: To evaluate the association of SH with QTc prolongation in adults with T2DM.

Methods: Prospective cohort analysis of participants enrolled in the ACCORD (Action to Control Cardiovascular Risk in Diabetes) study without QTc prolongation at baseline.

Diabetic kidney disease and risk of incident stroke among adults with type 2 diabetes.

Background: Data on the relations between kidney function abnormalities and stroke in type 2 diabetes are limited. We evaluated the associations of kidney function abnormalities and chronic kidney disease (CKD) stages with incident stroke in a large sample of adults with type 2 diabetes.

Methods: Participants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study without history of stroke at baseline were included.

Association of SGLT2 inhibitors with cardiovascular, kidney, and safety outcomes among patients with diabetic kidney disease: a meta-analysis.

Background: We conducted a systematic review and meta-analysis of the cardiovascular, kidney, and safety outcomes of sodium-glucose cotransporter 2 inhibitors (SGLT2i) among patients with diabetic kidney disease (DKD).

Methods: We searched electronic databases for major randomized placebo-controlled clinical trials published up to September 30, 2021 and reporting on cardiovascular and kidney outcomes of SGLT2i in patients with DKD. DKD was defined as chronic kidney disease in individuals with type 2 diabetes.

Body Weight Variability and Risk of Cardiovascular Outcomes and Death in the Context of Weight Loss Intervention Among Patients With Type 2 Diabetes.

Importance: Body weight fluctuation is associated with greater risks of adverse health outcomes. Whether intensive weight loss interventions affect the association of variability in adiposity measures with adverse health outcomes in individuals with type 2 diabetes has not been studied previously.

Objective: To evaluate the associations of long-term variability in adiposity indices with cardiovascular disease (CVD) outcomes and whether these associations are affected by an intensive lifestyle intervention among adults with type 2 diabetes.

Variability of adiposity indices and incident heart failure among adults with type 2 diabetes.

Background: It remains unclear how the variability of adiposity indices relates to incident HF. This study evaluated the associations of the variability in several adiposity indices with incident heart failure (HF) in individuals with type 2 diabetes (T2DM).

Methods: We included 4073 participants from the Look AHEAD (Action for Health in Diabetes) study.

Cardiac autonomic neuropathy and risk of incident heart failure among adults with type 2 diabetes.

Aims: Community-based data on the association between cardiac autonomic neuropathy (CAN) and incident heart failure (HF) in type 2 diabetes are limited. We evaluated the association of CAN with incident HF in adults with type 2 diabetes.

Methods And Results: This analysis included participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study without HF at baseline.

Correlates of cardiorespiratory fitness among overweight or obese individuals with type 2 diabetes.

Introduction: Mechanistic studies suggest that type 2 diabetes is independently associated with low cardiorespiratory fitness (CRF). Little is known about the CRF profile in type 2 diabetes; we assessed the correlates of low CRF among overweight/obese adults with type 2 diabetes.

Research Design And Methods: A total of 4215 participants with type 2 diabetes and without cardiovascular disease underwent maximal exercise testing in the Look AHEAD (Action for Health in Diabetes) study.

Association of plasma endothelin-1 with blood pressure progression among Blacks: The Jackson Heart Study.

Background: Despite pathophysiological links between endothelin (ET)-1 and hypertension in Black adults, there is no population-based data appraising the association of plasma ET-1 with longitudinal blood pressure (BP) changes in Blacks.

Methods: We analyzed data from 1197 Jackson Heart Study participants without hypertension (mean age 47.8 years [SD: 12.

Severe Hypoglycemia and Incident Heart Failure Among Adults With Type 2 Diabetes.

Context: The association of severe hypoglycemia on the incidence of heart failure (HF) is unclear.

Objective: We evaluated the association of severe hypoglycemia with incident HF among individuals with type 2 diabetes.

Methods: We included participants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study.