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Preventing Weight Gain and Controlling Blood Pressure During Smoking Cessation in Hypertensive Smokers

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00113074
Recruitment Status : Completed
First Posted : June 6, 2005
Last Update Posted : January 8, 2013
National Heart, Lung, and Blood Institute (NHLBI)
Information provided by (Responsible Party):
Mark Vander Weg, National Heart, Lung, and Blood Institute (NHLBI)

Brief Summary:
The purpose of this study is to develop effective interventions that assist individuals with high blood pressure to quit smoking and prevent weight gain.

Condition or disease Intervention/treatment Phase
Cardiovascular Diseases Heart Diseases Hypertension Drug: Nicotine Replacement Therapy Behavioral: Diet Not Applicable

Detailed Description:


High blood pressure (BP), or hypertension, is a major risk factor for cardiovascular morbidity and mortality. Hypertension is associated with an elevated risk for several cardiovascular complications, including coronary heart disease, peripheral vascular disease, congestive heart failure, and stroke, as well as an increased risk for renal disease. Although there have been significant advances in the detection and treatment of high BP, approximately one in four adults in the United States is hypertensive. Cigarette smoking accounts for more than 400,000 premature deaths each year in this country alone, making it the leading cause of morbidity and mortality. Evidence from several epidemiological studies has demonstrated that, at any level of BP, smoking substantially increases the risk for all cardiovascular complications associated with hypertension. While cigarette smoking and hypertension both increase the risk of cardiovascular disease, these two risk factors act synergistically to produce a greater risk than their combined independent effects. Despite the considerable health risks, smoking among people with hypertension is very common, with a prevalence approaching that observed among those with normal BP. Unfortunately, although quitting smoking is especially important for patients with high BP, smoking cessation produces a nontrivial weight gain, averaging 5 kg, which may exacerbate hypertension in many patients with the disorder. Several studies have documented significant elevations in BP following smoking cessation, as well as increases in the prevalence of hypertension after quitting smoking. As such, it is important to develop effective interventions that assist in quitting smoking and preventing weight gain.


The objective of the trial is to recruit 750 smokers with Stage 1 hypertension or prehypertension (based on JNC VII criteria). The trial will provide all participants with a brief, validated, combined behavioral and pharmacologic smoking cessation intervention. Additionally, the study will randomly assign participants who are abstinent from smoking upon completing the cessation intervention to either a 12-week weight management and BP control program or self-help materials targeting lifestyle modification. The primary endpoint is change in BP among quit smokers at a one-year follow-up. Secondary endpoints include changes in body weight, dietary intake, urinary sodium excretion, physical activity, and relapse to smoking. Exploratory endpoints include changes in hypertensive status (e.g., movement from prehypertensive to hypertensive by JNC VII criteria) and changes in BP medication status. This is a multi-site clinical trial, with study locations in Rochester, Minnesota, and Iowa City, IA. The Rochester, MN site is currently closed for recruitment.

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 376 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)
Primary Purpose: Prevention
Official Title: Blood Pressure Control in Hypertensive Smokers
Study Start Date : September 2004
Actual Primary Completion Date : June 2011
Actual Study Completion Date : June 2011

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Smoking

Arm Intervention/treatment
Active Comparator: 1
Weight management and BP control program
Drug: Nicotine Replacement Therapy
Nicotine replacement therapy program

Behavioral: Diet
Diet program

Active Comparator: 2
Self-help materials targeting lifestyle modification
Drug: Nicotine Replacement Therapy
Nicotine replacement therapy program

Behavioral: Diet
Diet program

Primary Outcome Measures :
  1. Change in BP among people who have quit smoking [ Time Frame: Measured at Year 1 ]

Secondary Outcome Measures :
  1. Changes in body weight [ Time Frame: Measured at Year 1 ]
  2. Dietary intake [ Time Frame: Measured at Year 1 ]
  3. Urinary sodium excretion [ Time Frame: Measured at Year 1 ]
  4. Physical activity [ Time Frame: Measured at Year 1 ]
  5. Relapse to smoking [ Time Frame: Measured at Year 1 ]

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  • Smoke at least 5 cigarettes/day (or have quit within the last 6 weeks to enter the study for the weight gain prevention and BP control interventions)
  • Pre-hypertensive or Stage I hypertension (systolic BP from 120 to 159 and/or diastolic BP from 80 to 99 mm Hg). Antihypertensive medications are not criteria for exclusion provided that BP is not over 160/100 mm Hg)
  • Access to a telephone

Exclusion Criteria:

  • History of unstable cardiovascular disease, including myocardial infarction, stroke, and unstable angina within three months of study start
  • Coronary artery bypass grafting or angioplasty/stent within three months of study start
  • Cardiac dysrhythmia treated with anti-arrhythmia medication, except stable atrial fibrillation
  • Untreated hyperthyroidism or pheochromocytoma
  • History of congestive heart failure (NYHA Class III or IV)
  • ECG evidence of 2nd or 3rd degree atrioventricular block
  • Uncontrolled or Stage II Hypertension as defined as BP consistently above 160/100 mm Hg
  • History of severe liver or kidney failure
  • Current substance abuse (includes alcohol use in excess of 21 drinks a week)
  • Presence of an unstable psychiatric condition
  • Severe chronic obstructive pulmonary disease
  • Symptomatic peripheral vascular disease
  • Pulmonary hypertension with shortness of breath
  • Congenital or valvular heart disease with shortness of breath
  • Current use of a medication that may interfere with primary study endpoints or that may increase the risk of side effects from study medication that cannot be discontinued
  • Pregnant or plans to become pregnant within the next year
  • Planning to move out of the area or travel extensively during the intervention
  • Any medical condition that would preclude any additional changes in diet
  • Unable to further modify physical activity routine
  • Cannot engage in moderate intensity exercise (e.g., walking)

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00113074

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United States, Iowa
University of Iowa, Carver College of Medicine, Department of Internal Medicine, Division of General Internal Medicine
Iowa City, Iowa, United States
United States, Minnesota
Mayo Clinic College of Medicine
Rochester, Minnesota, United States, 55905
Sponsors and Collaborators
University of Iowa
National Heart, Lung, and Blood Institute (NHLBI)
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Principal Investigator: Mark W. Vander Weg, PhD University of Iowa, Carver College of Medicine, Department of Internal Medicine
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Responsible Party: Mark Vander Weg, Mark W. Vander Weg, PhD, University of Iowa, National Heart, Lung, and Blood Institute (NHLBI) Identifier: NCT00113074    
Other Study ID Numbers: 179
R01HL072782 ( U.S. NIH Grant/Contract )
First Posted: June 6, 2005    Key Record Dates
Last Update Posted: January 8, 2013
Last Verified: January 2013
Additional relevant MeSH terms:
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Cardiovascular Diseases
Heart Diseases
Ganglionic Stimulants
Autonomic Agents
Peripheral Nervous System Agents
Physiological Effects of Drugs
Nicotinic Agonists
Cholinergic Agonists
Cholinergic Agents
Neurotransmitter Agents
Molecular Mechanisms of Pharmacological Action