The Effects of Nonpharmacologic Interventions on Blood Pressure of Persons With High Normal Levels: Results of the Trials of Hypertension Prevention, Phase I
TL;DR: Weight reduction is the most effective of the strategies tested for reducing blood pressure in normotensive persons, and sodium reduction is also effective.
Abstract: Objective. —To test the short-term feasibility and efficacy of seven nonpharmacologic interventions in persons with high normal diastolic blood pressure. Design. —Randomized control multicenter trials. Setting. —Volunteers recruited from the community, treated and followed up at special clinics. Participants. —Of 16821 screenees, 2182 men and women, aged 30 through 54 years, with diastolic blood pressure from 80 through 89 mm Hg were selected. Of these, 50 did not return for follow-up blood pressure measurements. Interventions. —Three life-style change groups (weight reduction, sodium reduction, and stress management) were each compared with unmasked nonintervention controls over 18 months. Four nutritional supplement groups (calcium, magnesium, potassium, and fish oil) were each compared singly, in double-blind fashion, with placebo controls over 6 months. Main Outcome Measures. —Primary: change in diastolic blood pressure from baseline to final follow-up, measured by blinded observers. Secondary: changes in systolic blood pressure and intervention compliance measures. Results. —Weight reduction intervention produced weight loss of 3.9 kg (P .05). Conclusions. —Weight reduction is the most effective of the strategies tested for reducing blood pressure in normotensive persons. Sodium reduction is also effective. The long-term effects of weight reduction and sodium reduction, alone and in combination, require further evaluation. (JAMA. 1992;267:1213-1220)
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TL;DR: The DBP results suggest that for the large majority of individuals, whether conventionally "hypertensive" or "normotensive", a lower blood pressure should eventually confer a lower risk of vascular disease.
4,397 citations
TL;DR: In this article, the authors present an overview of the main issues in epidemiology research and propose a method for controlling extraneous factors in the context of epidemiological studies, using Logistic Regression with Interaction, Effect Modification, and synergy.
Abstract: Key Issues in Epidemiologic Research: An Overview. OBJECTIVES AND METHODS OR EPIDEMIOLOGIC RESEARCH. Fundamentals of Epidemiologic Research. Types of Epidemiologic Research. Design Options in Observational Studies. Typology of Observational Study Designs. Measures of Disease Frequency: Incidence. Other Measures of Disease Frequency. Measures of Association. Measures of Potential Impact and Summary of the Measures. VALIDITY OF EPIDEMIOLOGIC RESEARCH. Validity: General Considerations. Selection Bias. Information Bias. Confounding. Confounding Involving Several Risk Factors. PRINCIPLES AND PROCEDURES OF EPIDEMIOLOGIC ANALYSIS. Statistical Inferences About Effect Measures: Simple Analysis. Overview of Options for Control of Extraneous Factors. Stratified Analysis. Matching in Epidemiologic Studies. Interaction, Effect Modification, and Synergism. Modeling: Theoretical Considerations. Modeling: Analysis Strategy. Applications of Modeling with No Interaction. Applications of Logistic Regression with Interaction, Using Unconditional ML Estimation. Applications of Modeling: Conditional Likelihood Estimation. Appendices. Index.
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01 Jan 1982
TL;DR: In this article, the authors present an overview of the main issues in epidemiology research and propose a method for controlling extraneous factors in the context of epidemiological studies, using Logistic Regression with Interaction, Effect Modification, and synergy.
Abstract: Key Issues in Epidemiologic Research: An Overview. OBJECTIVES AND METHODS OR EPIDEMIOLOGIC RESEARCH. Fundamentals of Epidemiologic Research. Types of Epidemiologic Research. Design Options in Observational Studies. Typology of Observational Study Designs. Measures of Disease Frequency: Incidence. Other Measures of Disease Frequency. Measures of Association. Measures of Potential Impact and Summary of the Measures. VALIDITY OF EPIDEMIOLOGIC RESEARCH. Validity: General Considerations. Selection Bias. Information Bias. Confounding. Confounding Involving Several Risk Factors. PRINCIPLES AND PROCEDURES OF EPIDEMIOLOGIC ANALYSIS. Statistical Inferences About Effect Measures: Simple Analysis. Overview of Options for Control of Extraneous Factors. Stratified Analysis. Matching in Epidemiologic Studies. Interaction, Effect Modification, and Synergism. Modeling: Theoretical Considerations. Modeling: Analysis Strategy. Applications of Modeling with No Interaction. Applications of Logistic Regression with Interaction, Using Unconditional ML Estimation. Applications of Modeling: Conditional Likelihood Estimation. Appendices. Index.
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