Patient ID
Clinical Center (A-D)
Randomization Date
Study Group (1-6)
Age (y) at Randomization
1=Male 2=Female
1=White,2=Black,3=Asian,4=Other
Birth Date
Income - Form 25 Q4
Marital Status - Form 25 Q5
Education - Form 25 Q6
Ever Smoke Cigarettes (1=Y, 2=N)
Now Smoke Cigarettes (1=Y, 2=N)
Amount Smoked/Day for Smokers
Height (inches)
Visit Date at 6 Months
Visit Date at 12 Months
Weight (lbs) at Baseline
Weight (lbs) at 6 Months
Weight (lbs) at 12 Months
Diastolic BP at Baseline
Diastolic BP at 6-Months
Diastolic BP at 12-Months
Systolic BP at Baseline
Systolic BP at 6-Months
Systolic BP at 12-Months
30 Second Pulse at Baseline
30 Second Pulse at 6 Months
30 Second Pulse at 12 Months
Values 1-7 BP Med Pres. 6-Months
Values 1-7 BP Med Pres. 12-Months
Total Cholesterol at Baseline
Total Cholesterol at 12-Months
HDL Cholesterol at Baseline
HDL Cholesterol at 12 Months
Blood Glucose at Baseline
Blood Glucose at 12 Months
Blood Potassium at Baseline
Blood Potassium at 12 Months
Urine Sodium at Baseline
Urine Sodium at 12 Months
Energy intake (kcal) at Baseline
Dietary Fat (%kcal) at Baseline
Protein (%kcal) at Baseline
Dietary Carbohydrates (%kcal) at Baseline
Dietary Cholesterol (mg) at Baseline
Dietary Calcium (mg) at Baseline
Dietary Sodium (mg) at Baseline
Dietary Potassium (mg) at Baseline
Dietary Alcohol (%kcal) at Baseline
Alcoholic Drinks/Week at Baseline
Alcoholic Drinks/Week at 12-Months
F020 Q10c Drowsiness-BL (Values 1-4)
F020 Q10d Tiredness-BL
F020 Q10f Faintness-BL
F020 Q10l Itchy Skin-BL
F020 Q10m Skin Rash- BL
F020 Q10p Headaches- BL
F020 Q10q Ringing in Ears- BL
F020 Q10r Stuffy Nose- BL
F020 Q10v Dry Mouth- BL
F020 Q10x Cough- BL
F020 Q10z Fast Heart Rate - BL
F020 Q10aa Chest Pain - BL
F020 Q10kk Joint Pain - BL
F020 Q10mm Swelling Feet- BL
F020 Q10nn Muscle Cramps- BL
F020 Q10pp Numbness- BL
F020 Q10qq Trouble Sleeping - BL
F020 Q10rr Waking up Early - BL
F020 Q10vv Mood Changes - BL
F020 Q10ww Depressed - BL
F140 Q10c Drowsiness-12 MO (Values 1-4)
F140 Q10d Tiredness-12 MO
F140 Q10f Faintness-12 MO
F140 Q10l Itchy Skin-12 MO
F140 Q10m Skin Rash- 12 MO
F140 Q10p Headaches- 12 MO
F140 Q10q Ringing in Ears- 12 MO
F140 Q10r Stuffy Nose- 12 MO
F140 Q10v Dry Mouth- 12 MO
F140 Q10x Cough- 12 MO
F140 Q10z Fast Heart Rate - 12 MO
F140 Q10aa Chest Pain - 12 MO
F140 Q10kk Joint Pain - 12 MO
F140 Q10mm Swelling Feet- 12 MO
F140 Q10nn Muscle Cramps- 12 MO
F140 Q10pp Numbness- 12 MO
F140 Q10qq Trouble Sleeping - 12 MO
F140 Q10rr Waking up Early - 12 MO
F140 Q10vv Mood Changes - 12 MO
F140 Q10ww Depressed - 12 MO
F135 Q81 f135genhlth 12mo
F135 Q82 f135hlthlimact 12mo
F135 Q83 f135diffwork 12mo
F135 Q84 f135satisfied 12mo
F135 Q85a f135excell 12mo
F135 Q85b f135wrshlth 12mo
F135 Q85c f135feelbad 12mo
F135 Q85d f135goodhlth 12mo
F135 Q85e f135feelgood 12mo
F135 Q86 f135extent 12mo
F135 Q87 f135frndsover 12mo
F135 Q88 f135theirhome 12mo
F135 Q89 f135limsocact 12mo
F135 Q90 f135interest 12mo
F135 Q91 f135wornout 12mo
F135 Q92 f135tense 12mo
F135 Q93 f135enufenergy 12mo
F135 Q94 f135blue 12mo
F135 Q95 f135happy 12mo
F135 Q96 f135worry 12mo
F135 Q97 f135lospirit 12mo
F135 Q98 f135calm 12mo
F135 Q99 f135pep 12mo
F135 Q100 f135nervous 12mo
F135 Q101 f135depres 12mo
F135 Q102 f135cheer 12mo
F135 Q103 f135fidgety 12mo
F135 Q104 f135dumps 12mo
F135 Q105 f135moody 12mo
F135 Q106 f135tired 12mo
F135 Q107A f135ill 12mo
F135 Q107B f135hlthlife 12mo
F135 Q107C f135poorhlth 12mo
F135 Q107D f135anybody 12mo
F135 Q107E f135unhealthy 12mo