Evidence map›Paper›PMID 34565172›Full record

Trial reportCirculation2021

Effects of Lifestyle Modification on Patients With Resistant Hypertension: Results of the TRIUMPH Randomized Clinical Trial.

James A Blumenthal, Alan L Hinderliter, Patrick J Smith, Stephanie Mabe, Lana L Watkins, Linda Craighead, Krista Ingle, Crystal Tyson, Pao-Hwa Lin, William E Kraus and 2 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Circulation, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02342808 (Treating Resistant Hypertension Using Lifestyle Modification to Promote Health), which is not on this map. Cited by 78 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
78citing papers in PubMed, 7 pooled it
–field-weighted citation impact
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.

NCT02342808 nacompletednot on this map

Treating Resistant Hypertension Using Lifestyle Modification to Promote Health

TypeinterventionalSponsorDuke UniversityRan2015 to 2020Enrolled140ConditionsTreatment-Resistant HypertensionArmsStructured center-based lifestyle intervention, Standard education and physician advice
3 · Its place in the literature

Who cites it

78 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  5. Impact of patient care teams on blood pressure control in patients with hypertension: a systematic review and meta-analysis.Hypertension research : official journal of the Japanese Society of Hypertension · 2025
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18 more citing papers are in PubMed but not listed here.

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

12 authors.

James A BlumenthalDepartment of Psychiatry and Behavioral Sciences (J.A.B., P.J.S., S.M., L.L.W., K.I., A.S.), Duke University Medical Center, Durham, NC.ORCID 0000-0003-3789-0935
Alan L HinderliterDepartment of Medicine, University of North Carolina at Chapel Hill (A.L.H.).
Patrick J SmithDepartment of Psychiatry and Behavioral Sciences (J.A.B., P.J.S., S.M., L.L.W., K.I., A.S.), Duke University Medical Center, Durham, NC.
Stephanie MabeDepartment of Psychiatry and Behavioral Sciences (J.A.B., P.J.S., S.M., L.L.W., K.I., A.S.), Duke University Medical Center, Durham, NC.
Lana L WatkinsDepartment of Psychiatry and Behavioral Sciences (J.A.B., P.J.S., S.M., L.L.W., K.I., A.S.), Duke University Medical Center, Durham, NC.
Linda CraigheadDepartment of Psychology, Emory University, Atlanta, GA (L.C.).
Krista IngleDepartment of Psychiatry and Behavioral Sciences (J.A.B., P.J.S., S.M., L.L.W., K.I., A.S.), Duke University Medical Center, Durham, NC.
Crystal TysonDepartment of Medicine (C.T., P.-H.L., W.E.K., L.L.), Duke University Medical Center, Durham, NC.
Pao-Hwa LinDepartment of Medicine (C.T., P.-H.L., W.E.K., L.L.), Duke University Medical Center, Durham, NC.
William E KrausDepartment of Medicine (C.T., P.-H.L., W.E.K., L.L.), Duke University Medical Center, Durham, NC.
Lawrence LiaoDepartment of Medicine (C.T., P.-H.L., W.E.K., L.L.), Duke University Medical Center, Durham, NC.
Andrew SherwoodDepartment of Psychiatry and Behavioral Sciences (J.A.B., P.J.S., S.M., L.L.W., K.I., A.S.), Duke University Medical Center, Durham, NC.

Funding

Facility and Web-based Approaches to Lifestyle Change in Resistant HypertensionR01HL122836 · NHLBI · DUKE UNIVERSITY · PI BLUMENTHAL, JAMES A, SHERWOOD, ANDREW · 2015 to 2019
$4.2M
Neurocognition, Lifestyle Modification, and Treatment Resistant HypertensionR01HL130237 · NHLBI · DUKE UNIVERSITY · PI SMITH, PATRICK JOSEY · 2016 to 2019
$1.0M
NHLBI NIH HHS R01 HL122836NHLBI NIH HHS R01 HL130237
6 · The paper itself

Abstract

backgroundAlthough lifestyle modifications generally are effective in lowering blood pressure (BP) among patients with unmedicated hypertension and in those treated with 1 or 2 antihypertensive agents, the value of exercise and diet for lowering BP in patients with resistant hypertension is unknown.

methodsOne hundred forty patients with resistant hypertension (mean age, 63 years; 48% female; 59% Black; 31% with diabetes; 21% with chronic kidney disease) were randomly assigned to a 4-month program of lifestyle modification (C-LIFE [Center-Based Lifestyle Intervention]) including dietary counseling, behavioral weight management, and exercise, or a single counseling session providing SEPA (Standardized Education and Physician Advice). The primary end point was clinic systolic BP; secondary end points included 24-hour ambulatory BP and select cardiovascular disease biomarkers including baroreflex sensitivity to quantify the influence of the baroreflex on heart rate, high-frequency heart rate variability to assess vagally mediated modulation of heart rate, flow-mediated dilation to evaluate endothelial function, pulse wave velocity to assess arterial stiffness, and left ventricular mass to characterize left ventricular structure.

resultsBetween-group comparisons revealed that the reduction in clinic systolic BP was greater in C-LIFE (-12.5 [95% CI, -14.9 to -10.2] mm Hg) compared with SEPA(-7.1 [-95% CI, 10.4 to -3.7] mm Hg) (

conclusionsDiet and exercise can lower BP in patients with resistant hypertension. A 4-month structured program of diet and exercise as adjunctive therapy delivered in a cardiac rehabilitation setting results in significant reductions in clinic and ambulatory BP and improvement in selected cardiovascular disease biomarkers. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02342808.

Indexed as

FemaleHumansHypertensionLife StyleMaleMiddle Agedcardiac rehabilitationDASH dietexercisehypertensionlifestyle

Identifiers

PMID34565172
PMCPMC8511053

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Registered trials

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.