Relationship Between Healthy Diet and Risk of Cardiovascular Disease Among Patients on Drug Therapies for Secondary Prevention

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 66.5Ϯ6.2 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 Ն55 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. Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT00153101.

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“…Patients with overt CHD and/or with diabetes mellitus are at an increased risk of cardiovascular events and dying from CHD. Lifestyle interventions, such as regular exercise, a healthy diet, weight loss, and smoking cessation, reduce the risk of adverse cardiovascular events (2)(3)(4). Controlling other risk factors, such as diabetes, arterial hypertension and hyperlipidemia, with pharmacotherapy also contributes to risk reduction (5).…”

Cardiovascular risk assessment in population from urban and sub urban areas of Eastern part of Odisha, India

“…Health professional's advice to individuals to improve their diet quality would substantially reduce CVD recurrence beyond drug therapy alone and save lives globally. 13 A study revealed that additional support in modifying lifestyles is useful in the reduction of cardiovascular disease risk. Change in individual risk factors: blood pressure, lipid profile, weight, body mass index, waist circumference, smoking, diabetes has been measured in the study.…”

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