Circulation. 2012 Dec 4;126(23):2705-12.
Relationship between healthy diet and risk of cardiovascular disease among patients on drug therapies for secondary prevention: a prospective cohort study of 31 546 high-risk individuals from 40 countries.
Dehghan M, Mente A, Teo KK, Gao P, Sleight P, Dagenais G, Avezum A, Probstfield JL, Dans T, Yusuf S; Ongoing Telmisartan Alone and in Combination With Ramipril Global End Point Trial (ONTARGET)/Telmisartan Randomized Assessment Study in ACEI Intolerant Subjects With Cardiovascular Disease (TRANSCEND) Trial Investigators.
Source
Population Health Research Institute, DBCVSRI, Hamilton General Hospital, 237
Barton St E, Hamilton, ON, Canada L8L 2X2. mahshid.dehghan@phri.ca
Abstract
BACKGROUND:
Diet quality is strongly related to cardiovascular disease (CVD) incidence, but
little is known about its impact on CVD events in older people at high risk of
CVD and receiving effective drugs for secondary prevention. This study assessed
the association between diet quality and CVD events in a large population of
subjects from 40 countries with CVD or diabetes mellitus with end-organ damage
receiving proven medications.
METHODS AND RESULTS:
Overall, 31 546 women and men 66.5±6.2 years of age enrolled in 2 randomized
trials, the Ongoing Telmisartan Alone and in Combination With Ramipril Global
End Point Trial (ONTARGET) and the Telmisartan Randomized Assessment Study in
ACEI Intolerant Subjects With Cardiovascular Disease (TRANSCEND), were studied.
We used 2 dietary indexes: the modified Alternative Healthy Eating Index and the
Diet Risk Score. The association between diet quality and the primary composite
outcome of CV death, myocardial infarction, stroke, or congestive heart failure
was assessed with Cox proportional hazard regression with adjustment for age,
sex, trial enrollment allocation, region, and other known confounders. During
the 56-month follow-up, there were 5190 events. Patients in the healthier
quintiles of modified Alternative Healthy Eating Index scores had a
significantly lower risk of CVD (hazard ratio, 0.78; 95% confidence interval,
0.71-0.87, top versus lowest quintile of modified Alternative Healthy Eating
Index). The reductions in risk for CV death, myocardial infarction, and stroke
were 35%, 14%, and 19%, respectively. The protective association was consistent
regardless of whether patients were receiving proven drugs.
CONCLUSIONS:
A higher-quality diet was associated with a lower risk of recurrent CVD events
among people >=55 years of age with CVD or diabetes mellitus. Highlighting the
importance of healthy eating by health professionals would substantially reduce
CVD recurrence and save lives globally.
PMID: 23212996 [PubMed - indexed for MEDLINE]