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.
RCT Entities:
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.
Authors: Shanshan Li; Stephanie E Chiuve; Alan Flint; Jennifer K Pai; John P Forman; Frank B Hu; Walter C Willett; Kenneth J Mukamal; Eric B Rimm Journal: JAMA Intern Med Date: 2013-10-28 Impact factor: 21.873
Authors: Esther Lopez-Garcia; Fernando Rodriguez-Artalejo; Tricia Y Li; Teresa T Fung; Shanshan Li; Walter C Willett; Eric B Rimm; Frank B Hu Journal: Am J Clin Nutr Date: 2013-10-30 Impact factor: 7.045
Authors: Tanushree Banerjee; Deidra C Crews; Delphine S Tuot; Meda E Pavkov; Nilka Rios Burrows; Austin G Stack; Rajiv Saran; Jennifer Bragg-Gresham; Neil R Powe Journal: Kidney Int Date: 2019-03-04 Impact factor: 10.612
Authors: Barbara Nußbaumer; Anna Glechner; Angela Kaminski-Hartenthaler; Peter Mahlknecht; Gerald Gartlehner Journal: Dtsch Arztebl Int Date: 2016-07-01 Impact factor: 5.594
Authors: Andrew Smyth; Mahshid Dehghan; Martin O'Donnell; Craig Anderson; Koon Teo; Peggy Gao; Peter Sleight; Gilles Dagenais; Jeffrey L Probstfield; Andrew Mente; Salim Yusuf Journal: Neurology Date: 2015-05-06 Impact factor: 9.910