Evidence map›Paper›PMID 31153659›Full record

Trial reportPatient education and counseling2019

Dose-dependent effects of lifestyle interventions on blood lipid levels: Results from the PREMIER trial.

Ramzi Dudum, Stephen P Juraschek, Lawrence J Appel

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Patient education and counseling, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 2 pooled it
1.3field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Ramzi DudumWelch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA; Department of Internal Medicine, The Johns Hopkins Hospital, Baltimore, MD, USA.
Stephen P JuraschekWelch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Lawrence J AppelWelch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA; Department of Epidemiology, Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: lappel1@jhmi.edu.
Johns Hopkins University · USBeth Israel Deaconess Medical Center · US

Funding

ZINC AND CA EDTA THERAPY OF PLUMBISMM01RR000052 · NCRR · JOHNS HOPKINS UNIVERSITY · PI VINING, EILEEN PATRICE · 1985 to 2007
$37.3M
Research BaseP30DK072488 · NIDDK · UNIVERSITY OF MARYLAND BALTIMORE · PI MITCHELL, BRAXTON D · 2005 to 2019
$17.3M
PREMIER--LIFESTYLE INTERVENE FOR BLOOD PRESSURE CONTRLU01HL060573 · NHLBI · KAISER FOUNDATION RESEARCH INSTITUTE · PI STEVENS, VICTOR J · 1998 to 2002
$2.5M
Vitamin D, Subclinical Cardiovascular Disease, and Orthostatic Hypotension in Older AdultsK23HL135273 · NHLBI · BETH ISRAEL DEACONESS MEDICAL CENTER · PI JURASCHEK, STEPHEN P · 2017 to 2021
$1.1M
NCRR NIH HHS M01 RR000052NHLBI NIH HHS K23 HL135273NHLBI NIH HHS U01 HL060573NIDDK NIH HHS P30 DK072488
6 · The paper itself

Abstract

objectiveTo assess the effects of comprehensive lifestyle modification on low-density lipoprotein cholesterol (LDL-C) levels and whether greater participation in counseling sessions was associated with greater LDL-C reductions.

methodsMulticenter trial of Pre- or Stage 1 hypertensive adults randomized to: (1)Advice alone, (2)'Established' lifestyle intervention implementing physical activity, sodium reduction, and weight loss, if overweight, or (3)'Established + DASH' lifestyle intervention with DASH diet counseling. Both intervention groups received behavioral counseling. We used generalized estimating equations to model the intervention's effects on lipid outcomes. Analyses of number of sessions and lipids were adjusted for demographics and medical history.

resultsAmong 756 participants (mean age 49.7, 63.2% women, 34.7% black), both lifestyle interventions reduced LDL-C, triglycerides, and total cholesterol (TC) at six months. Compared to the 'Advice' arm, net mean lipid changes in the Established group were: LDL-C of -5.6 mg/dL (p=0.001) and TC of -7.3 mg/dL (p<0.001). Similarly, changes in the 'Established + DASH' group were: LDL-C of -4.0 mg/dL (p=0.03) and TC of -5.7 mg/dL (p=0.006). In dose-response analyses, for every 10-session increase, LDL-C changed by -6.2 mg/dL (p=0.003).

conclusionsComprehensive lifestyle modification lowers LDL-C with greater benefit among persons who attend more counseling sessions. PRACTICE IMPLICATIONS: Patient engagement is a critical aspect of effective lifestyle interventions.

Indexed as

CounselingLife StyleCholesterol, LDLDietary Approaches To Stop HypertensionExerciseFemaleHumansHypertensionMaleMiddle AgedSodium, DietaryWeight LossCholesterol, LDLSodium, DietaryCardiovascular diseaseDietEpidemiologyLipidsPatient engagementRandomized trial

Identifiers

PMID31153659
PMCPMC6716987
OpenAlexW2945595725

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.