In Reply Dr Kawada correctly recognized that we did not observe an improvement in the overall mean body mass index (BMI; calculated as weight in kilograms divided by height in meters squared) of patients with peripheral arterial disease (PAD) enrolled in a risk-reduction program (mean [SD] BMI, 27.2 [3.6] at baseline vs 27.2 [5.6] at follow-up; mean difference, 0.0 [95% CI, −1.9 to 2.15]; P = .71).1 However, to contextualize this finding in a more clinically relevant manner, we converted BMI into a categorical variable based on the standard definitions of overweight (BMI ≥ 25) vs target weight (BMI < 25). We found that the proportion of patients who met the target BMI increased from 27% at baseline to 38% at follow-up, a significant difference (P = .05). Therefore, it appears that a subset of patients enrolled in the risk-reduction program were able to lose enough weight to meet their target BMI at follow-up.
Hussain MA, Al-Omran M, Lindsay TF. Risk-Reduction Program for Cardiovascular and Limb Events in Patients With Peripheral Arterial Disease—Reply. JAMA Surg. 2016;151(10):990-991. doi:10.1001/jamasurg.2016.2260