Evidence map›Paper›PMID 7479629›Full record

Trial reportPreventive medicine1995

Lifestyle intervention: results of the Treatment of Mild Hypertension Study (TOMHS).

P J Elmer, R Grimm, B Laing, G Grandits, K Svendsen, N Van Heel, E Betz, J Raines, M Link, J Stamler

2 registry-linked trialsAbstract readClinical TrialMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in Preventive medicine, 1995. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 42 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
42citing papers in PubMed, 7 pooled it
2.8field-weighted citation impact, top 9% 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.

NCT06948825 phase2recruitingstarted 2025, after this paper: background citation

Effectiveness Study of a Lifestyle Intervention Versus Metformin in Mothers With Recent Gestational Diabetes

Ran2025Enrolled60Registered outcomes12Posted comparisons0ConditionsGestational Diabetes Mellitus in Pregnancy, Postpartum Care, Weight LossArmsEnhanced Lifestyle Intervention, Lifestyle Intervention, Metformin Hcl 850Mg Tab
PMID 26840133PMID 11832527PMID 12436333PMID 11547793PMID 11333990PMID 9515998PMID 29683911PMID 28632867PMID 27654119PMID 26459420PMID 25526875PMID 24945238other papers from this trial
Open the trial in the graph
NCT00000522 phase2completednot on this map

Treatment of Mild Hypertension Study (TOMHS)

TypeinterventionalSponsorUniversity of MinnesotaRan1985 to 1994ConditionsCardiovascular Diseases, Heart Diseases, Hypertension, Vascular DiseasesArmsdiet, sodium-restricted, diet, reducing, exercise, alcohol restriction, chlorthalidone
3 · Its place in the literature

Who cites it

42 citing papers in PubMed, 7 syntheses or guidelines pooled it, 131 citations in OpenAlex.

  1. Pharmacotherapy for hypertension in adults 60 years or older.The Cochrane database of systematic reviews · 2019
    Pooled it
  2. Pharmacotherapy for hypertension in adults aged 18 to 59 years.The Cochrane database of systematic reviews · 2017
    Pooled it
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  4. Effect of longer-term modest salt reduction on blood pressure.The Cochrane database of systematic reviews · 2013
    Pooled it
  5. Advice to reduce dietary salt for prevention of cardiovascular disease.The Cochrane database of systematic reviews · 2004
    Pooled it
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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

10 authors at 3 institutions in 1 country.

P J ElmerDivision of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, USA.
R Grimm
B Laing
G Grandits
K Svendsen
N Van Heel
E Betz
J Raines
M Link
J Stamler
University of Minnesota · USTexas Health Dallas · USUniversity of Pittsburgh · US

Funding

TREATMENT OF MILD HYPERTENSION STUDY (TOMHS)R01HL034767 · UNIVERSITY OF MINNESOTA TWIN CITIES · 1985 to 1991
–
NHLBI NIH HHS R01-HL34767
6 · The paper itself

Abstract

backgroundQuestions regarding the efficacy of nonpharmacologic approaches for the treatment of stage 1 hypertension were addressed as part of the Treatment of Mild Hypertension Study (TOMHS), a 4-year, randomized clinical trial (N = 902). This report describes the lifestyle intervention program used in TOMHS, presents data on the lifestyle changes observed, and focuses on the effect of weight loss on blood pressure and blood lipid levels.

methodsParticipants were randomly assigned to receive either placebo or one of five different antihypertensive medications. All took part in a lifestyle intervention program to reduce weight and sodium and alcohol intake and to increase physical activity.

resultsSubstantial changes from baseline levels were achieved for all lifestyle intervention variables. Mean weight change was -10.5 lb (-5.6%) at 1 year, -8.5 lb (-4.5%) at 2 years, -7.4 lb (-4.0%) at 3 years, and -5.7 lb (-3.0%) at 4 years. At 4 years, 70% of participants remained below baseline weight and 34% maintained a weight loss of 10 lb or greater. Mean change in urinary sodium excretion was -12.5 mmol/8 hr (-23%) at 1 year, -10.7 mmol/8 hr (-20%) at 2 years, -8.4 mmol/8 hr (-16%) at 3 years, and -4.6 mmol/8 hr (-9%) at 4 years. Alcohol intake declined by 1.6 drinks/week among drinkers at 4 years. Reported leisure physical activity increased by 86% at 1 year and remained 50% above baseline at 4 years. Beneficial changes in blood pressure and serum lipids were associated with these changes.

conclusionsThese results support a role for lifestyle interventions as the initial treatment for stage 1 hypertension and demonstrate that such interventions can be successfully implemented in the clinical setting.

Indexed as

Health EducationLife StyleAgedAlcohol DrinkingBehavior TherapyBlood PressureBody WeightCholesterolDietDouble-Blind MethodExerciseFemaleHumansHypertensionMaleMiddle AgedCholesterolSodium

Identifiers

PMID7479629
OpenAlexW2119009229

What Socratic holds

Textmetadata
Read underepoch 390

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 Socratic graph.