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

¹ a senior research associate at the Center for Health Research, Kaiser Permanente Northwest, in Portland, Oregon.
² a senior investigator in epidemiology and nutrition at the Center for Health Research, Kaiser Permanente Northwest, in Portland, Oregon.
³ a senior investigator at the Center for Health Research, Kaiser Permanente Northwest in Portland, Oregon.
⁴ an associate professor in the Body Composition Laboratory at Pennington Biomedical Research Center in Baton Rouge, Louisiana.
⁵ a health behavior researcher at the Center for Health Research, Kaiser Permanente Northwest, in Portland, Oregon.
⁶ an associate research professor at the Sarah Stedman Center for Nutritional Studies at Duke University Medical Center in Durham, North Carolina.
⁷ an associate professor in the Department of Kinesiology at the University of Maryland in College Park, Maryland.
⁸ a professor in the Dietary Assessment and Food Analysis Core Department at Pennington Biomedical Research Center in Baton Rouge, Louisiana.
⁹ the director of the Division of Education, and professor and chief of the Behavioral Medicine Laboratory at Pennington Biomedical Research Center in Baton Rouge, Louisiana.
¹⁰ director of intervention at the Welch Center for Prevention, Epidemiology and Clinical Research in Baltimore, Maryland.
¹¹ Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute, National Institutes of Health, in Bethesda, Maryland.
¹² a professor of medicine, epidemiology, and international health at the Johns Hopkins School of Medicine in Baltimore, Maryland.

^* To whom correspondence should be addressed.

	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.

Key Words: hypertension, diet, physical activity, behavioral intervention, blood pressure, DASH

First published on June 27, 2006, doi:10.1177/1524839906289035

Health Promotion Practice 2008;9:271.

A more recent version of this article appeared on July 1, 2008


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