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4 April 2006, Vol 144, No. 7>
Articles | 4 April 2006

Effects of Comprehensive Lifestyle Modification on Diet, Weight, Physical Fitness, and Blood Pressure Control: 18-Month Results of a Randomized Trial

Patricia J. Elmer, PhD; Eva Obarzanek, PhD; William M. Vollmer, PhD; Denise Simons-Morton, MD, PhD; Victor J. Stevens, PhD; Deborah Rohm Young, PhD; Pao-Hwa Lin, PhD; Catherine Champagne, PhD; David W. Harsha, PhD; Laura P. Svetkey, MD; Jamy Ard, MD; Phillip J. Brantley, PhD; Michael A. Proschan, PhD; Thomas P. Erlinger, MD, MPH; Lawrence J. Appel, MD, PREMIER Collaborative Research Group
[+] Article and Author Information

From Kaiser Permanente Northwest, Portland, Oregon; National Heart, Lung, and Blood Institute, Bethesda, Maryland; University of Maryland, College Park, Maryland; Duke University Medical Center, Durham, North Carolina; Pennington Biomedical Research Center, Baton Rouge, Louisiana; University of Alabama, Birmingham, Alabama; and Johns Hopkins Medical Institutions, Baltimore, Maryland.


ClinicalTrials.gov Identifier: NCT00000616

Acknowledgments: The authors thank the PREMIER participants for their sustained commitment to the trial, the staff members from the participating sites, and the members of the trial's data and safety monitoring board.

Grant Support: By National Heart, Lung, and Blood Institute (National Institutes of Health) grants UO1 HL60570, UO1 HL60571, UO1 HL60573, UO1 HL60574, and UO1 HL62828.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: William M. Vollmer, PhD, Center for Health Research, Kaiser Permanente Northwest, 3800 North Interstate Avenue, Portland, OR 97227; e-mail, William.Vollmer@kpchr.org.

Current Author Addresses: Dr. Elmer: 3927 NE Tillamook, Portland, OR 97212.

Drs. Obarzanek and Simons-Morton: National Heart, Lung, and Blood Institute, Division of Epidemiology and Clinical Applications, 6701 Rockledge Drive, MSC 7936, Room 8136, Bethesda, MD 20892.

Drs. Vollmer and Stevens: Center for Health Research, Kaiser Permanente Northwest, 3800 North Interstate Avenue, Portland, OR 97227.

Dr. Rohm Young: Department of Kinesiology, Room 2312, HHP Building, University of Maryland, College Park, MD 20741.

Dr. Lin: Duke University Medical Center, Box 3487, Durham, NC 27710.

Drs. Champagne and Harsha: Pennington Biomedical Research Center, Nutritional Epidemiology and Dietary Assessment and Counseling, Louisiana State University System, 6400 Perkins Road, Baton Rouge, LA 70808-4124.

Dr. Svetkey: Duke University Medical Center, Box 3075, Durham, NC 27710.

Dr. Ard: Division of Clinical Nutrition & Dietetics, University of Alabama at Birmingham, 441 Webb Nutrition Sciences Building, 1675 University Boulevard, Birmingham, AL 35294-3360.

Dr. Brantley: Behavioral Medicine Laboratory, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808-4124.

Dr. Proschan: National Heart, Lung, and Blood Institute, Division of Epidemiology and Clinical Applications, 6701 Rockledge Drive, MSC 7938, Bethesda, MD 20892.

Dr. Erlinger: Department of Internal Medicine, University of Texas Medical Branch, Austin, Brackenridge Hospital Annex, 0.255, 601 East 15th Street, Austin, TX 78701.

Dr. Appel: Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, 2024 East Monument Street, Suite 2-618, Baltimore, MD 21205.

Author Contributions: Conception and design: P.J. Elmer, E. Obarzanek, W.M. Vollmer, D. Simons-Morton, V.J. Stevens, D. Rohm Young, P.-H. Lin, C. Champagne, D.W. Harsha, L.P. Svetkey, P.J. Brantley, L.J. Appel.

Analysis and interpretation of the data: P.J. Elmer, E. Obarzanek, W.M. Vollmer, D. Simons-Morton, V.J. Stevens, P.-H. Lin, D.W. Harsha, L.P. Svetkey, J. Ard, L.J. Appel.

Drafting of the article: P.J. Elmer, W.M. Vollmer, V.J. Stevens, D.W. Harsha, L.P. Svetkey, L.J. Appel.

Critical revision of the article for important intellectual content: P.J. Elmer, E. Obarzanek, W.M. Vollmer, D. Simons-Morton, V.J. Stevens, D. Rohm Young, P.-H. Lin, D.W. Harsha, L.P. Svetkey, J. Ard, P.J. Brantley, M.A. Proschan, T.P. Erlinger, L.J. Appel.

Final approval of the article: P.J. Elmer, E. Obarzanek, W.M. Vollmer, D. Simons-Morton, V.J. Stevens, D. Rohm Young, D.W. Harsha, L.P. Svetkey, J. Ard, P.J. Brantley, T.P. Erlinger, L.J. Appel.

Provision of study materials or patients: P.-H. Lin, L.P. Svetkey, L.J. Appel.

Statistical expertise: W.M. Vollmer, M.A. Proschan.

Obtaining of funding: P.J. Elmer, W.M. Vollmer, V.J. Stevens, L.P. Svetkey, L.J. Appel.

Administrative, technical, or logistic support: E. Obarzanek, D. Simons-Morton, V.J. Stevens, C. Champagne.

Collection and assembly of data: V.J. Stevens, C. Champagne, L.P. Svetkey, L.J. Appel.


Ann Intern Med. 2006;144(7):485-495. doi:10.7326/0003-4819-144-7-200604040-00007
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The PREMIER study design and rationale (19) and intervention methods (11) have been described previously. The institutional review boards at each clinical center; an external protocol review committee appointed by the National Heart, Lung, and Blood Institute (NHLBI); and the NHLBI reviewed and approved the protocol (Available at http://www.kpchr.org/public/premier/intervention/default.asp). The NHLBI also appointed a data and safety monitoring board to monitor the trial. Each participant provided written informed consent. The trial was conducted from January 2000 through November 2002.

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Summary for Patients

The Effects of Lifestyle Changes on Long-Term Blood Pressure Control

The summary below is from the full report titled “Effects of Comprehensive Lifestyle Modification on Diet, Weight, Physical Fitness, and Blood Pressure Control: 18-Month Results of PREMIER. A Randomized Trial.” It is in the 4 April 2006 issue of Annals of Internal Medicine (volume 144, pages 485-495). The authors are P.J. Elmer, E. Obarzanek, W.M. Vollmer, D. Simons-Morton, V.J. Stevens, D. Rohm Young, P.-H. Lin, C. Champagne, D.W. Harsha, L.P. Svetkey, J. Ard, P.J. Brantley, M.A. Proschan, T.P. Erlinger, and L.J. Appel, for the PREMIER Collaborative Research Group.

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