PREMIER—A Trial of Lifestyle Interventions for Blood Pressure Control: Intervention Design and Rationale

Funk, Kristine L.; Elmer, Patricia J.; Stevens, Victor J.; Harsha, David W.; Craddick, Shirley R.; Lin, Pao-Hwa; Young, Deborah Rohm; Champagne, Catherine M.; Brantley, Phillip J.; McCarron, Phyllis B.; Simons-Morton, Denise G.; Appel, Lawrence J.

doi:10.1177/1524839906289035

Cited by 74Blood Pressure and Hypertension StudiesSodium Intake and HealthHealth Promotion and Cardiovascular Prevention

PREMIER—A Trial of Lifestyle Interventions for Blood Pressure Control: Intervention Design and Rationale

Funk, Kristine L., Elmer, Patricia J., Stevens, Victor J., Harsha, David W., Craddick, Shirley R., Lin, Pao-Hwa, Young, Deborah Rohm, Champagne, Catherine M. +4 more·2008·Health Promotion Practice

DOI 10.1177/1524839906289035

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Abstract

Interventions encouraging adoption of healthy diets and increased physical activity are needed to achieve national goals for preventing and treating hypertension, cardiovascular disease, diabetes, and other chronic diseases. PREMIER was a multicenter clinical trial testing the effects of two lifestyle interventions on blood pressure control, compared with advice only. Both interventions implemented established national guidelines for blood pressure control (weight loss, reduced sodium and alcohol intake, and increased physical activity), and one intervention also included the Dietary Approaches to Stop Hypertension (DASH) diet. Both interventions focused on behavioral self-management, motivational enhancement, and personalized feedback. This article describes the design and evaluation approaches for these interventions. Evaluation of multicomponent lifestyle change interventions can help us understand the benefits and difficulties of making multiple lifestyle changes concurrently and the effects such changes can have on blood pressure, particularly in minorities at higher risk for hypertension.

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The DASH pattern focuses on increasing intake of plant and lean meat/fish/dairy micronutrients associated with lowering blood pressure (potassium, calcium, magnesium) and limiting macronutrients and micronutrients associated with increased blood pressure (saturated fat, added sugars, sodium).
“The DASH pattern is focused on increasing the intake of plant and lean meat/fish/dairy micronutrients associated with lowering blood pressure (potassium, calcium, and magnesium) and limiting macronutrients and micronutrients associated with increased blood pressure (saturated fat, added sugars, and sodium).12-18”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [14]
In the PREMIER trial, only 28% of participants met sodium targets (eg, <1500 mg/d) at 6 months, although it was relatively feasible to meet the target of <2300 mg/d by avoiding processed foods.
“Notably, in the PREMIER trial (PREMIER: Lifestyle Interventions for Blood Pressure Control), only 28% of participants met sodium targets (eg, <1500 mg/d) at 6 months, although it was relatively feasible to meet the target of <2300 mg/d by avoiding processed foods.14,70”
From Popular dietary patterns: alignment with American Heart Association 2021 dietary guidance: a scientific statement from the American Heart Association. (2023) · cites this paper as [14]

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Premier: a clinical trial of comprehensive lifestyle modification for blood pressure control: rationale, design and baseline characteristics
Svetkey, L. P., Harsha, D. W., Vollmer, W. M., Stevens, V. J., Obarzanek, E., Elmer, P. J., Lin, P., Champagne, C. M., Simons‐Morton, D. G., Aickin, M. G., et al. (2003) · Annals of Epidemiology · doi:10.1016/s1047-2797(03)00006-1 · Cited by 147 · see citing works
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Authors: Funk, K. L., Elmer, P. J., Stevens, V. J., Harsha, D. W., Craddick, S. R., Lin, P.-H., Young, D. R., Champagne, C. M., Brantley, P. J., McCarron, P. B., Simons-Morton, D. G., & Appel, L. J.
Affiliations: Kaiser Permanente (US)
Pennington Biomedical Research Center (US)
Duke University (US)
University of Maryland, College Park (US)
Welch Center for Prevention, Epidemiology and Clinical Research in Baltimore, Maryland
Division of Epidemiology and Clinical Applications, National Heart, Lung, Blood Institute, National Institutes of Health, in Bethesda, Maryland
Johns Hopkins University (US)
ORCID: Lin, Pao-Hwa
Young, Deborah Rohm
Champagne, Catherine M.
Appel, Lawrence J.
Venue: Health Promotion Practice
Publisher: SAGE Publications
Published: 2006-06-27
Volume: 9
Issue: 3
Pages: 271-280
ISSN: 1524-8399 (ISSN-L)
1552-6372
DOI: 10.1177/1524839906289035
OpenAlex: W2112667549
Cited by: 74
References: 41
Citations by year: 2025: 1 · 2024: 2 · 2023: 2 · 2021: 4 · 2020: 1 · 2019: 2 · 2018: 6 · 2017: 3 · 2016: 1 · 2015: 6 · 2014: 5 · 2013: 7 · 2012: 8
FWCI: 3.55
Type: journal article
Language: en
Open access: closed
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations: Health Promotion Practice (publishedVersion)
PubMed (publishedVersion)
Funders: National Heart, Lung, and Blood Institute (U01HL060571, U01 HL60574, U01 HL605700, U01 HL60573, U01HL62828, U01HL060574, U01HL062828, U01HL060573, U01 HL60571)
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Health Sciences › Nursing › Nutrition and Dietetics › Sodium Intake and Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords: hypertension, blood pressure control, lifestyle intervention, DASH diet, weight loss, sodium intake, alcohol consumption, physical activity, behavioral self-management, motivation enhancement, personalized feedback, multicomponent intervention, minority groups, PREMIER trial
MeSH terms: Adult, Black or African American, Diet, Sodium-Restricted, Female, Health Promotion, Humans, Hypertension, Longitudinal Studies, Male, Middle Aged, Motor Activity, Risk Reduction Behavior, White People

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PREMIER—A Trial of Lifestyle Interventions for Blood Pressure Control: Intervention Design and Rationale

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