| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Circulation. 1999;99:779-785.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Mediterranean Diet, Traditional Risk Factors, and the Rate of Cardiovascular Complications After Myocardial Infarction
Final Report of the Lyon Diet Heart Study
From Explorations Fonctionnelles Cardiorespiratoires et Métaboliques, CHU de Saint-Etienne (M.d.L., P.S., I.M.), Saint-Etienne; and INRETS Epidemiology Unit (J.L.M.), Hôpital Cardiovasculaire (J.D.) and INSERM Unit 265 (N.M.), Lyon, France.
Correspondence to Dr M. de Lorgeril, Explorations Fonctionnelles Cardiorespiratoires et Métaboliques, Niveau 6, CHU Nord, 42055 Saint-Etienne Cedex 2, France. E-mail lorgeril{at}univ-st-etienne.fr
 |
Abstract |
|---|
 Top Abstract IntroductionMethodsResultsDiscussionReferences |
|---|
Background—The Lyon Diet Heart Study is a randomized secondary prevention trial aimed at testing whether a Mediterranean-type diet may reduce the rate of recurrence after a first myocardial infarction. An intermediate analysis showed a striking protective effect after 27 months of follow-up. This report presents results of an extended follow-up (with a mean of 46 months per patient) and deals with the relationships of dietary patterns and traditional risk factors with recurrence.
Methods and Results—Three composite outcomes (COs) combining either cardiac death and nonfatal myocardial infarction (CO 1), or the preceding plus major secondary end points (unstable angina, stroke, heart failure, pulmonary or peripheral embolism) (CO 2), or the preceding plus minor events requiring hospital admission (CO 3) were studied. In the Mediterranean diet group, CO 1 was reduced (14 events versus 44 in the prudent Western-type diet group, P=0.0001), as were CO 2 (27 events versus 90, P=0.0001) and CO 3 (95 events versus 180, P=0.0002). Adjusted risk ratios ranged from 0.28 to 0.53. Among the traditional risk factors, total cholesterol (1 mmol/L being associated with an increased risk of 18% to 28%), systolic blood pressure (1 mm Hg being associated with an increased risk of 1% to 2%), leukocyte count (adjusted risk ratios ranging from 1.64 to 2.86 with count >9x109/L), female sex (adjusted risk ratios, 0.27 to 0.46), and aspirin use (adjusted risk ratios, 0.59 to 0.82) were each significantly and independently associated with recurrence.
Conclusions—The protective effect of the Mediterranean dietary pattern was maintained up to 4 years after the first infarction, confirming previous intermediate analyses. Major traditional risk factors, such as high blood cholesterol and blood pressure, were shown to be independent and joint predictors of recurrence, indicating that the Mediterranean dietary pattern did not alter, at least qualitatively, the usual relationships between major risk factors and recurrence. Thus, a comprehensive strategy to decrease cardiovascular morbidity and mortality should include primarily a cardioprotective diet. It should be associated with other (pharmacological?) means aimed at reducing modifiable risk factors. Further trials combining the 2 approaches are warranted.
Key Words: diet • trials • coronary disease • myocardial infarction
|
Introduction |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Recent dietary trials in secondary prevention of coronary heart disease (CHD) reported impressive reduction of the recurrence rate by a range of 30% to 70%.1 2 3 These were in contrast with previous dietary trials, which were aimed at reducing blood cholesterol by a low-cholesterol, low-saturated-fat, high-polyunsaturated-fat diet and failed to significantly improve the overall clinical prognosis of the dieters.4 The successful trials tested dietary patterns characterized by a low intake of total and saturated fats2 3 and/or increased intake of marine1 or plant
-3 fatty acids2 3 and
were not intended primarily to reduce blood cholesterol.
Two of these trials2 3 also included a high intake of
fresh fruits and vegetables, legumes, and cereals containing large
amounts of fibers, antioxidants, minerals, vegetable proteins, and
vitamins of the B group. The credibility of these recent trials was
considerably reinforced by a number of recent studies showing major
cardioprotective effects of most of these foods and
nutrients,5 6 7 8 9 10 11 12 13 14 with a particular emphasis on -3 fatty
acids8 9 and on folates for their role in
hyperhomocysteinemia and in the arginine–nitric
oxide–tetrahydrobiopterin pathway,10 11 12 13 14 2
possible major mediators in the development of CHD. The Lyon Diet Heart Study is a randomized, single-blind secondary prevention trial aimed at testing whether a Mediterranean-type diet, compared with a prudent Western-type diet, may reduce recurrence after a first myocardial infarction.3 We previously reported a significant reduction of the rates of cardiovascular complications,3 15 and no major bias was detected in the trial.16 However, despite confluent epidemiological and clinical data supporting the results,5 6 7 8 9 10 11 12 13 14 certain commentators put forth the relatively small number of events, the wide CIs of the risk ratios at the intermediate analysis, and hence the uncertainty regarding the true reduction of risk. In this report, we present data resulting from an extended follow-up, providing a total of 275 events over a mean follow-up of 46 months per patient. We also examined the relationships between traditional risk factors, dietary patterns, and the occurrence of complications.
|
Methods |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
The design, methods, and results of an intermediate analysis of the Lyon Diet Heart Study have been reported.3 15 16 Briefly, consecutive patients who survived a first myocardial infarction were randomized between March 1988 and March 1992. Eligible patients were <70 years old, were clinically stable, and had no medical or social conditions that would limit their ability to participate in a dietary trial.
Inclusion of patients was based on a modified Zelen design.17 Briefly, during their stay in hospital, patients were asked to participate in a cohort study with a follow-up of 5 years. They were not fully informed about the design of the study, especially regarding the comparison of 2 diets. Patients assigned to the experimental group were asked to comply with a Mediterranean-type diet and had to sign a second consent form. Patients of the control group received no dietary advice from the investigators but nonetheless were advised to follow a prudent diet by their attending physicians.3
An intermediate analysis was proposed by the Scientific
Committee to be performed in March 1993, clinical data being frozen
after a minimum follow-up of 1 year for each patient. Because of a
statistically significant result, the decision was made to stop the
trial. The first report was published in June 1994.3 For
ethical, medical, and scientific reasons, all patients were invited to
come to the Research Unit for a final visit, during which they were
fully informed about the main results of the trial. Hence, given the
delay after the clinical status of the 2 groups in March 1993, the
decision to invite the patients to a new assessment, and the time
needed to see each patient, an additional follow-up of 
19 months was
available in the 2 groups to perform the final analyses. This
offered the opportunity to evaluate the long-term (mean, 4 years)
effect of the diet tested in the trial and whether the patients
continued to comply with it.
As in the previous analysis, only clinical events requiring hospital admission were considered. The End-Point Committee met for a final and blinded evaluation of the raw data obtained from hospital files and, for patients who had died, from the civil status office of the patient's birthplace. Definitions of the end points were reported previously,3 15 16 and the basic principles of the experimental diet have been described.3 15 16 In practical terms, the dietary instructions were detailed and customized to each patient,16 and a dietary survey at each visit allowed us to check for adhesion and compliance to the experimental diet. In addition, plasma fatty acids were analyzed (gas-liquid chromatography) in the 2 groups as described3 and used as objective biomarkers.
Analyses were done on the intention-to-treat principle. Event-free survival for myocardial infarction, cardiovascular death, and 3 composite outcomes (COs) were estimated by the Kaplan-Meier method. The censoring date was the date of the earliest event or the end of follow-up. The Cox proportional-hazards model was used to calculate the risk ratios and to quantify the associations between each traditional risk factor and the different COs, namely myocardial infarction plus cardiovascular death (CO 1); myocardial infarction plus cardiovascular death plus major secondary events including episodes of unstable angina, as previously defined,3 15 episodes of overt heart failure, stroke, or pulmonary or peripheral embolism (CO 2); or the preceding plus minor events requiring hospital admission, including recurrent stable angina, postangioplasty restenosis, surgical or medical myocardial revascularization, and thrombophlebitis (CO 3). Also considered in a separate analysis were the medications recorded 2 months after randomization. Because the use of lipid-lowering drugs varied considerably during the study in France, these drugs were not included in these analyses. This point has been described and analyzed elsewhere.16
|
Results |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
The great majority (93.4% of control and 92.4% of experimental subjects) of patients still alive and not censored at the time of the final visit in the 2 groups agreed to come to the Research Unit. Among the patients who did not come for a final visit (15 control and 19 experimental), the vital status was unknown for 4 patients (3 control and 1 experimental). Mean follow-up for survival was 44.9 months in the control group and 46.7 months in the experimental group. The numbers and rates of new events are shown in Table 1
. All-cause and
cardiovascular (P=0.01) mortality and the
combination of recurrent myocardial infarction and cardiac death (CO 1,
P=0.0001) were reduced. The combined major primary and
secondary end points (CO 2, 90 events versus 27 and CO 3, 180 events
versus 95, giving an adjusted risk ratio of 0.53, P=0.0002)
were also reduced. Event-free survival curves are shown in Figures 1 through 3.
|
|
|
|
Main cardiovascular risk (or prognosis) factors and the
mean daily nutrient intake recorded on the final visit are given in
Tables 2 and 3. Data are quite similar to those
recorded at and 2 months after randomization.3
|
|
Univariate associations between major risk factors
recorded 2 months after randomization (data not shown) and the 3
composite outcomes are shown in Table 4.
Among the medications used (data not shown), only aspirin was
significantly (and inversely) associated with the outcomes and was then
included in the multivariate analyses. A
threshold effect was observed with leukocyte count (quartile
analyses), with a markedly increased risk when the count was
>9x109/L. Thus, leukocyte count was used as a
categorical variable, whereas total cholesterol and
blood pressure (no J-shaped curve) were used as continuous
variables in further analyses.
|
With regard to any association between the plasma concentration of
major fatty acids and recurrence, only 18:3(-3) and
22:6(-3) tended to be inversely associated with recurrence
(P=0.11 and P=0.16, respectively, versus CO
1).
Then, the effect of traditional risk factors on recurrence was
analyzed with the multivariate Cox
proportional-hazards model (Table 5).
When the plasma fatty acid concentrations were entered into the model,
18:3(-3) was the only fatty acid significantly associated with CO 1
(risk ratio, 0.20; 95% CIs, 0.05 to 0.84 after adjustment for age,
sex, smoking, total cholesterol, blood pressure, leukocyte
count, and aspirin use). With regard to the effect of 18:3(-3) on CO
2 and CO 3, the associations were borderline nonsignificant
(P=0.08 and P=0.12).
|
|
Discussion |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
Including a total of 275 events recorded during a mean follow-up of 46 months, this report shows that longer follow-up and inclusion of more events in the analyses do not substantially alter the picture in the Lyon Study and confirms the results of the intermediate analysis.3 15 Also, the influence of the risk factors on prognosis was similar to that reported in other low-risk populations, indicating that a low-fat Mediterranean diet does not qualitatively alter the usual relationships between the risk factors and recurrence rate.
Mediterranean Dietary Pattern and Recurrence
The rate of cardiac death and nonfatal infarction in the
experimental group after 46 months (1.24 per hundred patients per year)
is similar to that observed after 27 months (1.32). The rate in control
subjects was 4.07 after 46 months, whereas it was 5.55 after 27
months.3 Hence, the data confirm the impressive protective
effect of the Mediterranean diet.
It has been argued that it is easier to prescribe drugs than to change the dietary habits of patients, a task often considered to be difficult; and unfortunately, after some attempts, many physicians do give up. This study shows that several years after randomization, most experimental patients were still closely following the Mediterranean diet recommended to them. This suggests, in contrast to the current opinion, that the adoption of and compliance with new dietary habits is not so difficult, provided that the instruction of patients (and of their families) and surveillance are properly (professionally) conducted.16 Of course, the new dietary habits need to be financially and gastronomically acceptable and practically feasible for patients (and their relatives) who often have to adapt to a difficult working environment and the stressful urban way of life. Finally, it should be emphasized that taking 1 or several drugs prescribed by their attending physician, as most of the patients did in the 2 groups of the present trial, is not incompatible with the adoption of new dietary habits. This trial even supports the view that pharmacological treatment (for instance, with aspirin) and dietary prevention had additional and independent beneficial effects.
Blood Pressure, Smoking, Cardiovascular
Medications, and Recurrence
In multivariate analyses, blood pressure,
but not smoking, was significantly and independently associated with
recurrence. It should be noted, however, that we did not
analyze the effect of the true blood pressure of each patient
because many of them were taking at least 1 pressure-lowering drug as
part of a systematic secondary prevention treatment.
In secondary prevention, it is usually the effect of current (and not past) smoking that is analyzed. In the present cohort, <20% of the patients in the 2 groups were current smokers on the final visit. It is therefore likely that, in this population with a low prevalence of smoking, the number of events was too small and the length of follow-up too short to allow an actual evaluation of the true effect of persistent smoking.
The effects of cardiac medications in this study were quite disappointing, because only aspirin was consistently associated with a protective effect. However, the study was not designed primarily to test these medications, and data should be interpreted cautiously. It is nonetheless noteworthy that, in secondary prevention, the effect of ß-blockers was shown to be quite small18 and that such low efficacy was probably difficult to demonstrate in a low-risk population. The same reasoning can apply to calcium channel blockers, whose effect (either protective or deleterious) is the object of a bitter controversy.19
Plasma Fatty Acids and Recurrence
Major difficulties in randomized dietary trials are the prevention
of "attending physician bias"16 and between-group
contamination during follow-up. For that purpose, patients were not
fully informed that they were participating in a dietary trial with the
comparison of 2 diets. The lack of knowledge of that comparison by the
patients of both groups (and by their attending physicians) may
minimize the physician bias.16 Thus, in the first part of
the study, the dietary habits of the control patients were not
investigated and recorded so as not to influence them.
Consequently, we cannot include their dietary parameters in
the Cox model to prospectively analyze their relationships with
recurrence. Instead, we used the plasma fatty acids measured 2
months after randomization as crude estimates of dietary data. Only
-linolenic acid was significantly associated with an
improved prognosis, which is in agreement with a recent study reporting
a negative correlation between the intake of -linolenic acid
and the risk of myocardial infarction.20 Conversely, we
did not find any correlation between long-chain -3 fatty acid and
recurrence. Several animal21 and
clinical1 2 3 8 9 studies, however, have shown the
beneficial effects of these fatty acids on CHD, whereas a few studies
were apparently inconsistent, even putting forth the hypothesis
that high dosages may be noxious.22 In moderate amounts,
such as are consumed in the traditional Mediterranean diet, the
protective effects of -3 fatty acids are probably related to their
multiple actions on the various factors that modulate the cascade of
events leading to acute myocardial ischemia and its acute
complications, in particular sudden death.23 It is likely
that the lack of significant correlations (although a trend toward
protection was observed) in this study may be partly explained by the
relatively small number of sudden deaths and fatal myocardial
infarctions, which are apparently the main types of complications
prevented by moderate consumption of these fatty
acids.8 9
Blood Cholesterol, Leukocyte Count, and
Recurrence
As expected, total cholesterol and leukocyte count
were major independent and joint predictors of recurrence,
along with the dietary pattern. A leukocyte count
>9x109/L increased the risk by a factor of 1.6
to 2.9, and each increase of 1 mmol/L of total
cholesterol increased the risk of recurrence by
20% to 30%. Epidemiological studies have consistently shown a
positive correlation between plasma cholesterol levels and
the incidence of (and mortality from) CHD in various
populations.24 25 Thus, our population does not appear to
be different from other low-risk populations.25 26 In
other words, the data indicate that neither the Mediterranean dietary
pattern nor any major bias has altered the usual and expected
relationships between the major risk factors of CHD and
recurrence.
Leukocyte count also has been shown to be a marker for increased risk
of CHD mortality in many studies.27 In most studies, this
effect is partly independent of smoking. A plausible mechanism to
explain this relationship is that leukocytes are involved not only in
the inflammation and ulceration of the arterial
lesion28 but also in the exacerbation of acute myocardial
ischemia. This may ultimately result in an increased infarct
size, the major determinant of postinfarction survival. Experimental
studies have indeed suggested the implication of leukocytes in acute
myocardial ischemia,29 and human and animal
studies have consistently shown that leukocytes play a role in
the severity of ventricular arrhythmias during
ischemia.29 30 In this study, high leukocyte count
was associated with an increased risk of major acute coronary
events, such as cardiac death and acute infarction (risk ratio, 3),
whereas the association was lower (risk ratio, 1.6) when recurrent
stable angina and the need for myocardial
revascularization were considered, suggesting that
leukocytes are more important in acute myocardial complications than in
the development of subacute coronary artery lesions.
|
Acknowledgments |
|---|
We thank Dr François Paillard (Cardiologist, University Hospital Rennes, France) and Dr Alberto Righetti (Cardiologist, University Hospital, Geneva, Switzerland) as members of the Validation and Classification Committee.
Received June 14, 1998; revision received October 14, 1998; accepted October 26, 1998.
|
References |
|---|
|
TopAbstractIntroductionMethodsResultsDiscussionReferences |
|---|
1. Burr ML, Fehily AM, Gilbert JF, Rogers S, Holliday RM, Sweetnam PM, Elwood PC, Deadman NM. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet. 1989;2:757–761.[Medline] [Order article via Infotrieve]
2. Singh RB, Rastogi SS, Verma R, Laxmi B, Singh R, Ghosh S, Niaz MA. Randomised controlled trial of cardioprotective diet in patients with recent acute myocardial infarction: results of one year follow-up. BMJ. 1992;304:1015–1019.
3. de Lorgeril M, Renaud S, Mamelle N, Salen P, Martin JL, Monjaud I, Guidollet J, Touboul P, Delaye J. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet. 1994;343:1454–1459.[Medline] [Order article via Infotrieve]
4. de Lorgeril M, Salen P, Monjaud I, Delaye J. The diet heart hypothesis in secondary prevention of coronary heart disease. Eur Heart J. 1997;18:14–18.
5.
Gilman MW, Cupples LA, Gagnon D, Posner BM, Ellison
RC, Castelli WP, Wolf PA. Protective effect of fruits and vegetables on
development of stroke in men. JAMA. 1995;273:1113–1117.
6.
Rimm EB, Ascherio A, Giovannucci E, Spiegelman D,
Stampfer MJ, Willett WC. Vegetable, fruit and cereal fiber intake and
risk of coronary heart disease among men. JAMA. 1996;275:447–451.
7.
Key TJ, Thorogood M, Appleby PN, Burr ML. Dietary
habits and mortality in 11000 vegetarians and health conscious people:
results of a 17 year follow up. BMJ. 1996;313:775–779.
8.
Albert CM, Hennekens CH, O'Donnell CJ, Ajani UA,
Carey VJ, Willett WC, Ruskin JN, Manson JE. Fish consumption and risk
of sudden death. JAMA. 1998;279:23–28.
9.
Daviglus ML, Stamler J, Orencia AJ, Dyer AR, Liu K,
Greenland P, Walsh MK, Morris D, Shekelle RB. Fish consumption and the
30-year risk of fatal myocardial infarction. N Engl J
Med. 1997;336:1046–1053.
10.
Robinson K, Arheart K, Refsum H, Brattström T,
Boers G, Ueland P, Rubba P, Palma-Reis R, Meleady R, Daly L, Witteman
J, Graham I. Low circulating folate and vitamin
B6 concentrations: risk factors for stroke,
peripheral vascular disease, and coronary heart
disease. Circulation. 1998;97:437–443.
11.
Stampfer MJ, Rimm EB. Folate and
cardiovascular disease: why we need a trial now.
JAMA. 1996;275:1929–1930.
12.
Verhaar MC, Wever RM, Kastelein JJ, van Dam T, Koomans
A, Rabelink TJ. 5-Methyltetrahydrofolate, the active form of folic
acid, restores endothelial function in familial
hypercholesterolemia. Circulation. 1998;97:237–241.
13.
Wever RM, Lüscher TF, Cosentino F, Rabelink TJ.
Atherosclerosis and the two faces of
endothelial nitric oxide synthase.
Circulation. 1998;97:108–112.
14.
de Lorgeril M. Dietary arginine in prevention of
cardiovascular diseases. Cardiovasc Res. 1998;37:560–563.
15. de Lorgeril M, Salen P, Martin JL, Mamelle N, Monjaud I, Touboul P, Delaye J. Effect of a Mediterranean-type of diet on the rate of cardiovascular complications in coronary patients: insights into the cardioprotective effect of certain nutriments. J Am Coll Cardiol. 1996;28:1103–1108.[Abstract]
16. de Lorgeril M, Salen P, Caillat-Vallet E, Monjaud I, Hanauer MT, Mamelle N. Control of bias in dietary trial to prevent coronary recurrences: the Lyon Diet Heart Study. Eur J Clin Nutr. 1997;51:116–122.[Medline] [Order article via Infotrieve]
17. Zelen M. A new design for randomized clinical trials. N Engl J Med. 1979;300:1242–1245.[Abstract]
18. Yusuf S, Peto R, Lewis JA, Collins R, Sleight P. Beta-blockade during and after myocardial infarction: an overview of the randomized trials. Prog Cardiovasc Dis. 1985;27:335–371.[Medline] [Order article via Infotrieve]
19.
Furberg CD, Psaty BM, Meyer JV. Nifedipine:
dose-related increase in mortality in patients with coronary
heart disease. Circulation. 1995;92:1326–1331.
20.
Ascherio A, Rimm EB, Giovannucci EL, Spiegelman D,
Stampfer M, Willett WC. Dietary fat and risk of coronary heart
disease in men: cohort follow up study in the United States.
BMJ. 1996;313:84–90.
21.
Billman GE, Hallaq H, Leaf A. Prevention of
ischemia-induced ventricular fibrillation by
3 fatty acids. Proc Natl Acad Sci U S A. 1994;91:4427–4430.
22.
Katan MB. Fish and heart disease. N Engl
J Med. 1995;332:1024–1025.
23.
Leaf A. Cardiovascular effects of fish
oils. Circulation. 1990;82:624–628.
24.
Stamler J, Wentworth D, Neaton JD. Is relationship
between serum cholesterol and risk of premature death from
coronary heart disease continuous and graded? Findings in
356,222 primary screenees of the Multiple Risk Factors Intervention
Trial (MRFIT). JAMA. 1986;256:2823–2828.
25.
Verschuren WMM, Jacobs DR, Bloemberg BPM, Kromhout D,
Menotti A, Aravanis C, Blackburn H, Buzina R, Dontas AS, Fidanza F,
Karvonen MJ, Nedeljkovic S, Nissinen A, Toshima H. Serum total
cholesterol and long-term coronary heart disease
mortality in different cultures. JAMA. 1995;274:131–136.
26.
Fraser GE, Strahan TM, Sabaté J, Beeson L,
Kissinger D. Effect of traditional coronary risk factors on
rates of incident coronary events in a low-risk
population: the Adventist Health Study. Circulation. 1992;86:406–413.
27.
Kannel WB, Anderson K, Wilson PWF. White blood cell
count and cardiovascular disease: insights from the
Framingham Study. JAMA. 1992;267:1253–1256.
28.
Buja LM, Willerson JT. Role of inflammation in
coronary plaque disruption. Circulation. 1994;89:503–505.
29. de Lorgeril M, Basmadjian A, Lavallée M, Clément R, Millette D, Rousseau G, Latour JG. Influence of leukopenia on collateral flow, reperfusion flow, reflow ventricular fibrillation, and infarct size in dogs. Am Heart J. 1989;117:523–532.[Medline] [Order article via Infotrieve]
30. Kuzuya T, Hoshida S, Suzuki K, Sasaki T, Kitabatake A, Kamada T, Minamino T, Tada M. Polymorphonuclear leukocyte activity and ventricular arrhythmia in acute myocardial infarction. Am J Cardiol. 1988;62:868–872.We report results of a secondary prevention trial testing a Mediterranean dietary pattern and examine the relationships between diet, risk factors, and recurrence. A total of 275 events were recorded over a mean follow-up of 46 months. In the Mediterranean group, overall (P=0.03) and cardiac (P=0.01) mortalities were reduced. Outcomes combining cardiac deaths, nonfatal infarction, and secondary end points were also reduced (P<0.0005), with risk ratios ranging from 0.28 to 0.53. Total cholesterol, blood pressure, leukocyte count, aspirin use, and female sex were independent and joint predictors of recurrence. Thus, a comprehensive strategy to reduce cardiovascular mortality and morbidity should primarily include a cardioprotective diet.[Medline] [Order article via Infotrieve]
This article has been cited by other articles:
 |
|
 |
|
  P. M Kris-Etherton Adherence to dietary guidelines: benefits on atherosclerosis progression Am. J. Clinical Nutrition, July 1, 2009; 90(1): 13 - 14. [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Becker, R. Y. Gordon, S. C. Halbert, B. French, P. B. Morris, and D. J. Rader Red Yeast Rice for Dyslipidemia in Statin-Intolerant Patients: A Randomized Trial Ann Intern Med, June 16, 2009; 150(12): 830 - 839. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. B Panagiotakos, K. Dimakopoulou, K. Katsouyanni, T. Bellander, M. Grau, W. Koenig, T. Lanki, R. Pistelli, A. Schneider, A. Peters, et al. Mediterranean diet and inflammatory response in myocardial infarction survivors Int. J. Epidemiol., June 1, 2009; 38(3): 856 - 866. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Thomson, M. P. Frenneaux, and J. C. Kaski Antioxidant treatment for heart failure: friend or foe? QJM, May 1, 2009; 102(5): 305 - 310. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. R Jacobs Jr, M. D Gross, and L. C Tapsell Food synergy: an operational concept for understanding nutrition Am. J. Clinical Nutrition, May 1, 2009; 89(5): 1543S - 1548S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. O. McCall, C. P. McGartland, M. C. McKinley, C. C. Patterson, P. Sharpe, D. R. McCance, I. S. Young, and J. V. Woodside Dietary Intake of Fruits and Vegetables Improves Microvascular Function in Hypertensive Subjects in a Dose-Dependent Manner Circulation, April 28, 2009; 119(16): 2153 - 2160. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J.A. Jenkins, J. L. Sievenpiper, D. Pauly, U. R. Sumaila, C. W.C. Kendall, and F. M. Mowat Are dietary recommendations for the use of fish oils sustainable? Can. Med. Assoc. J., March 17, 2009; 180(6): 633 - 637. [Full Text] [PDF]
|
|
|
|
|
|
T. T. Fung, K. M. Rexrode, C. S. Mantzoros, J. E. Manson, W. C. Willett, and F. B. Hu Mediterranean Diet and Incidence of and Mortality From Coronary Heart Disease and Stroke in Women Circulation, March 3, 2009; 119(8): 1093 - 1100. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. A. Schmitt, E. H. Heiss, Y. Aristei, T. Severin, and V. M. Dirsch Norfuraneol dephosphorylates eNOS at threonine 495 and enhances eNOS activity in human endothelial cells Cardiovasc Res, March 1, 2009; 81(4): 750 - 757. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Scarmeas, Y. Stern, R. Mayeux, J. J. Manly, N. Schupf, and J. A. Luchsinger Mediterranean Diet and Mild Cognitive Impairment Arch Neurol, February 1, 2009; 66(2): 216 - 225. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Mascitelli, F. Pezzetta, and M. R. Goldstein Letter to the Editor American Journal of Lifestyle Medicine, January 1, 2009; 3(1): 74 - 74. [PDF]
|
|
|
|
|
|
J. B. Brill The Mediterranean Diet and Your Health American Journal of Lifestyle Medicine, January 1, 2009; 3(1): 44 - 56. [Abstract] [PDF]
|
|
|
|
|
|
M.-P. Mena, E. Sacanella, M. Vazquez-Agell, M. Morales, M. Fito, R. Escoda, M. Serrano-Martinez, J. Salas-Salvado, N. Benages, R. Casas, et al. Inhibition of circulating immune cell activation: a molecular antiinflammatory effect of the Mediterranean diet Am. J. Clinical Nutrition, January 1, 2009; 89(1): 248 - 256. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-A. Cornier, D. Dabelea, T. L. Hernandez, R. C. Lindstrom, A. J. Steig, N. R. Stob, R. E. Van Pelt, H. Wang, and R. H. Eckel The Metabolic Syndrome Endocr. Rev., December 1, 2008; 29(7): 777 - 822. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G Ferns, V Keti, and B Griffin Investigation and management of hypertriglyceridaemia J. Clin. Pathol., November 1, 2008; 61(11): 1174 - 1183. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. A. Amin, R. A. Menon, K. J. Reid, W. S. Harris, and J. A. Spertus Acute Coronary Syndrome Patients With Depression Have Low Blood Cell Membrane Omega-3 Fatty Acid Levels Psychosom Med, October 1, 2008; 70(8): 856 - 862. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Barcelo-Coblijn, E. J Murphy, R. Othman, M. H Moghadasian, T. Kashour, and J. K Friel Flaxseed oil and fish-oil capsule consumption alters human red blood cell n-3 fatty acid composition: a multiple-dosing trial comparing 2 sources of n-3 fatty acid Am. J. Clinical Nutrition, September 1, 2008; 88(3): 801 - 809. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Rowbotham and P. Clayton An unsuitable and degraded diet? Part three: Victorian consumption patterns and their health benefits J R Soc Med, September 1, 2008; 101(9): 454 - 462. [Full Text] [PDF]
|
|
|
|
 |
|
 R. M Merrill, S. G Aldana, R. L Greenlaw, A. Salberg, and H. Englert Chronic disease risk reduction with a community-based lifestyle change programme Health Education Journal, September 1, 2008; 67(3): 219 - 230. [Abstract] [PDF]
|
|
|
|
 |
|
 P. Gresele, P. Pignatelli, G. Guglielmini, R. Carnevale, A. M. Mezzasoma, A. Ghiselli, S. Momi, and F. Violi Resveratrol, at Concentrations Attainable with Moderate Wine Consumption, Stimulates Human Platelet Nitric Oxide Production J. Nutr., September 1, 2008; 138(9): 1602 - 1608. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M Berg, G. Lappas, E. Strandhagen, A. Wolk, K. Toren, A. Rosengren, N. Aires, D. S Thelle, and L. Lissner Food patterns and cardiovascular disease risk factors: The Swedish INTERGENE research program Am. J. Clinical Nutrition, August 1, 2008; 88(2): 289 - 297. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Karatzi, C. Papamichael, E. Karatzis, T. G. Papaioannou, P. Th. Voidonikola, G. D. Vamvakou, J. Lekakis, and A. Zampelas Postprandial Improvement of Endothelial Function by Red Wine and Olive Oil Antioxidants: A Synergistic Effect of Components of the Mediterranean Diet J. Am. Coll. Nutr., August 1, 2008; 27(4): 448 - 453. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Blaha, S. Bansal, R. Rouf, S. H. Golden, R. S. Blumenthal, and A. P. DeFilippis A Practical 'ABCDE' Approach to the Metabolic Syndrome Mayo Clin. Proc., August 1, 2008; 83(8): 932 - 943. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Campos, A. Baylin, and W. C. Willett {alpha}-Linolenic Acid and Risk of Nonfatal Acute Myocardial Infarction Circulation, July 22, 2008; 118(4): 339 - 345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. S. Harris Cardiovascular Risk and {alpha}-Linolenic Acid: Can Costa Rica Clarify? Circulation, July 22, 2008; 118(4): 323 - 324. [Full Text] [PDF]
|
|
|
|
|
|
E. Warensjo, J. Sundstrom, B. Vessby, T. Cederholm, and U. Riserus Markers of dietary fat quality and fatty acid desaturation as predictors of total and cardiovascular mortality: a population-based prospective study Am. J. Clinical Nutrition, July 1, 2008; 88(1): 203 - 209. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. J. Becker, R. Y. Gordon, P. B. Morris, J. Yorko, Y. J. Gordon, M. Li, and N. Iqbal Simvastatin vs Therapeutic Lifestyle Changes and Supplements: Randomized Primary Prevention Trial Mayo Clin. Proc., July 1, 2008; 83(7): 758 - 764. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M A Martinez-Gonzalez, C d. l. Fuente-Arrillaga, J M Nunez-Cordoba, F J Basterra-Gortari, J J Beunza, Z Vazquez, S Benito, A Tortosa, and M Bes-Rastrollo Adherence to Mediterranean diet and risk of developing diabetes: prospective cohort study BMJ, June 14, 2008; 336(7657): 1348 - 1351. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Mozaffarian, P. W.F. Wilson, and W. B. Kannel Beyond Established and Novel Risk Factors: Lifestyle Risk Factors for Cardiovascular Disease Circulation, June 10, 2008; 117(23): 3031 - 3038. [Full Text] [PDF]
|
|
|
|
|
|
S. S. Bassuk and J. E. Manson Lifestyle and Risk of Cardiovascular Disease and Type 2 Diabetes in Women: A Review of the Epidemiologic Evidence American Journal of Lifestyle Medicine, June 1, 2008; 2(3): 191 - 213. [Abstract] [PDF]
|
|
|
|
 |
|
 N. Kandasamy, F. Joseph, and N. Goenka Review: The role of omega-3 fatty acids in cardiovascular disease, hypertriglyceridaemia and diabetes mellitus The British Journal of Diabetes & Vascular Disease, May 1, 2008; 8(3): 121 - 126. [Abstract] [PDF]
|
|
|
|
 |
|
 Y.-F. Xiao, D. C. Sigg, M. R. Ujhelyi, J. J. Wilhelm, E. S. Richardson, and P. A. Iaizzo Pericardial delivery of omega-3 fatty acid: a novel approach to reducing myocardial infarct sizes and arrhythmias Am J Physiol Heart Circ Physiol, May 1, 2008; 294(5): H2212 - H2218. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Austria, M. N. Richard, M. N. Chahine, A. L. Edel, L. J. Malcolmson, C. M.C. Dupasquier, and G. N. Pierce Bioavailability of Alpha-Linolenic Acid in Subjects after Ingestion of Three Different Forms of Flaxseed J. Am. Coll. Nutr., April 1, 2008; 27(2): 214 - 221. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-C. Toufektsian, M. de Lorgeril, N. Nagy, P. Salen, M. B. Donati, L. Giordano, H.-P. Mock, S. Peterek, A. Matros, K. Petroni, et al. Chronic Dietary Intake of Plant-Derived Anthocyanins Protects the Rat Heart against Ischemia-Reperfusion Injury J. Nutr., April 1, 2008; 138(4): 747 - 752. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. R. Skilton Intrauterine Risk Factors for Precocious Atherosclerosis Pediatrics, March 1, 2008; 121(3): 570 - 574. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Kaul, R. Kreml, J. A. Austria, M. N. Richard, A. L. Edel, E. Dibrov, S. Hirono, M. E. Zettler, and G. N. Pierce A Comparison of Fish Oil, Flaxseed Oil and Hempseed Oil Supplementation on Selected Parameters of Cardiovascular Health in Healthy Volunteers J. Am. Coll. Nutr., February 1, 2008; 27(1): 51 - 58. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Goulet, B. Lamarche, and S. Lemieux A Nutritional Intervention Promoting a Mediterranean Food Pattern Does Not Affect Total Daily Dietary Cost in North American Women in Free-Living Conditions J. Nutr., January 1, 2008; 138(1): 54 - 59. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tao, M. A. McDowell, S. H. Saydah, and M. S. Eberhardt Relationship of Polyunsaturated Fatty Acid Intake to Peripheral Neuropathy Among Adults With Diabetes in the National Health and Nutrition Examination Survey (NHANES) 1999 2004 Diabetes Care, January 1, 2008; 31(1): 93 - 95. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. E. O'Neil and T. A. Nicklas State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health American Journal of Lifestyle Medicine, December 1, 2007; 1(6): 457 - 481. [Abstract] [PDF]
|
|
|
|
|
|
F. A. Muskiet, R. S Kuipers, E. N Smit, and J. C. Joordens The basis of recommendations for docosahexaenoic and arachidonic acids in infant formula: absolute or relative standards? Am. J. Clinical Nutrition, December 1, 2007; 86(6): 1802 - 1803. [Full Text] [PDF]
|
|
|
|
 |
|
 T. Mildestvedt, E. Meland, and G. E. Eide No difference in lifestyle changes by adding individual counselling to group-based rehabilitation RCT among coronary heart disease patients Scand J Public Health, December 1, 2007; 35(6): 591 - 598. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Dalziel and L. Segal Time to give nutrition interventions a higher profile: cost-effectiveness of 10 nutrition interventions Health Promot. Int., December 1, 2007; 22(4): 271 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Mozaffarian Free fatty acids, cardiovascular mortality, and cardiometabolic stress Eur. Heart J., November 2, 2007; 28(22): 2699 - 2700. [Full Text] [PDF]
|
|
|
|
|
|
V. Vuksan, D. Whitham, J. L. Sievenpiper, A. L. Jenkins, A. L. Rogovik, R. P. Bazinet, E. Vidgen, and A. Hanna Supplementation of Conventional Therapy With the Novel Grain Salba (Salvia hispanica L.) Improves Major and Emerging Cardiovascular Risk Factors in Type 2 Diabetes: Results of a randomized controlled trial Diabetes Care, November 1, 2007; 30(11): 2804 - 2810. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. N. Toft, L. H. Kristoffersen, M. Aadahl, L. von Huth Smith, C. Pisinger, and T. Jorgensen Diet and exercise intervention in a general population mediators of participation and adherence: the Inter99 study Eur J Public Health, October 1, 2007; 17(5): 455 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ayalew-Pervanchon, D. Rousseau, D. Moreau, P. Assayag, P. Weill, and A. Grynberg Long-term effect of dietary {alpha}-linolenic acid or decosahexaenoic acid on incorporation of decosahexaenoic acid in membranes and its influence on rat heart in vivo Am J Physiol Heart Circ Physiol, October 1, 2007; 293(4): H2296 - H2304. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. C. Dupasquier, E. Dibrov, A. L. Kneesh, P. K. M. Cheung, K. G. Y. Lee, H. K. Alexander, B. K. Yeganeh, M. H. Moghadasian, and G. N. Pierce Dietary flaxseed inhibits atherosclerosis in the LDL receptor-deficient mouse in part through antiproliferative and anti-inflammatory actions Am J Physiol Heart Circ Physiol, October 1, 2007; 293(4): H2394 - H2402. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Scarmeas, J. A. Luchsinger, R. Mayeux, and Y. Stern Mediterranean diet and Alzheimer disease mortality Neurology, September 11, 2007; 69(11): 1084 - 1093. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. London, C. Albert, M. E. Anderson, W. R. Giles, D. R. Van Wagoner, E. Balk, G. E. Billman, M. Chung, W. Lands, A. Leaf, et al. Omega-3 Fatty Acids and Cardiac Arrhythmias: Prior Studies and Recommendations for Future Research: A Report from the National Heart, Lung, and Blood Institute and Office of Dietary Supplements Omega-3 Fatty Acids and Their Role in Cardiac Arrhythmogenesis Workshop Circulation, September 4, 2007; 116(10): e320 - e335. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Fito, M. Guxens, D. Corella, G. Saez, R. Estruch, R. de la Torre, F. Frances, C. Cabezas, M. d. C. Lopez-Sabater, J. Marrugat, et al. Effect of a Traditional Mediterranean Diet on Lipoprotein Oxidation: A Randomized Controlled Trial Arch Intern Med, June 11, 2007; 167(11): 1195 - 1203. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A Nettleton, L. M Steffen, M. B Schulze, N. S Jenny, R G. Barr, A. G Bertoni, and D. R Jacobs Jr Associations between markers of subclinical atherosclerosis and dietary patterns derived by principal components analysis and reduced rank regression in the Multi-Ethnic Study of Atherosclerosis (MESA) Am. J. Clinical Nutrition, June 1, 2007; 85(6): 1615 - 1625. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Chrysohoou, D. B Panagiotakos, C. Pitsavos, J. Skoumas, X. Krinos, Y. Chloptsios, V. Nikolaou, and C. Stefanadis Long-term fish consumption is associated with protection against arrhythmia in healthy persons in a Mediterranean region--the ATTICA study Am. J. Clinical Nutrition, May 1, 2007; 85(5): 1385 - 1391. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Ungvari, Z. Orosz, A. Rivera, N. Labinskyy, Z. Xiangmin, S. Olson, A. Podlutsky, and A. Csiszar Resveratrol increases vascular oxidative stress resistance Am J Physiol Heart Circ Physiol, May 1, 2007; 292(5): H2417 - H2424. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. E. Boden, R. A. O'Rourke, K. K. Teo, P. M. Hartigan, D. J. Maron, W. J. Kostuk, M. Knudtson, M. Dada, P. Casperson, C. L. Harris, et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease N. Engl. J. Med., April 12, 2007; 356(15): 1503 - 1516. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. J. Sheridan, J. N. Cooper, M. Erario, and C. E. Cheifetz Pistachio Nut Consumption and Serum Lipid Levels J. Am. Coll. Nutr., April 1, 2007; 26(2): 141 - 148. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Vos, D. J. Jenkins, and S. C Cunnane {alpha}-Linolenic acid and fish oil n 3 fatty acids and cardiovascular disease risk Am. J. Clinical Nutrition, March 1, 2007; 85(3): 920 - 921. [Full Text] [PDF]
|
|
|
|
|
|
J. Lau, W. S Harris, and A. H Lichtenstein Reply to E Vos et al Am. J. Clinical Nutrition, March 1, 2007; 85(3): 921 - 922. [Full Text] [PDF]
|
|
|
|
|
|
B. Halliwell Dietary polyphenols: Good, bad, or indifferent for your health? Cardiovasc Res, January 15, 2007; 73(2): 341 - 347. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. J. Dzau, E. M. Antman, H. R. Black, D. L. Hayes, J. E. Manson, J. Plutzky, J. J. Popma, and W. Stevenson The Cardiovascular Disease Continuum Validated: Clinical Evidence of Improved Patient Outcomes: Part I: Pathophysiology and Clinical Trial Evidence (Risk Factors Through Stable Coronary Artery Disease) Circulation, December 19, 2006; 114(25): 2850 - 2870. [Full Text] [PDF]
|
|
|
|
|
|
N. Scarmeas, Y. Stern, R. Mayeux, and J. A. Luchsinger Mediterranean Diet, Alzheimer Disease, and Vascular Mediation Arch Neurol, December 1, 2006; 63(12): 1709 - 1717. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Cao, K. A. Schwichtenberg, N. Q. Hanson, and M. Y. Tsai Incorporation and Clearance of Omega-3 Fatty Acids in Erythrocyte Membranes and Plasma Phospholipids Clin. Chem., December 1, 2006; 52(12): 2265 - 2272. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. M. C. Dupasquier, A.-M. Weber, B. P. Ander, P. P. Rampersad, S. Steigerwald, J. T. Wigle, R. W. Mitchell, E. A. Kroeger, J. S. C. Gilchrist, M. M. Moghadasian, et al. Effects of dietary flaxseed on vascular contractile function and atherosclerosis during prolonged hypercholesterolemia in rabbits Am J Physiol Heart Circ Physiol, December 1, 2006; 291(6): H2987 - H2996. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. J. Mukamal, S. E. Chiuve, and E. B. Rimm Alcohol consumption and risk for coronary heart disease in men with healthy lifestyles. Arch Intern Med, October 23, 2006; 166(19): 2145 - 2150. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.F. Oliver Sudden cardiac death: the lost fatty acid hypothesis QJM, October 1, 2006; 99(10): 701 - 709. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Csiszar, K. Smith, N. Labinskyy, Z. Orosz, A. Rivera, and Z. Ungvari Resveratrol attenuates TNF-{alpha}-induced activation of coronary arterial endothelial cells: role of NF-{kappa}B inhibition. Am J Physiol Heart Circ Physiol, October 1, 2006; 291(4): H1694 - H1699. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Developed in Collaboration With the European Heart, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death: A Report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J. Am. Coll. Cardiol., September 5, 2006; 48(5): e247 - e346. [Full Text] [PDF]
|
|
|
|
|
|
N. O'Kennedy, L. Crosbie, M. van Lieshout, J. I Broom, D. J Webb, and A. K Duttaroy Effects of antiplatelet components of tomato extract on platelet function in vitro and ex vivo: a time-course cannulation study in healthy humans. Am. J. Clinical Nutrition, September 1, 2006; 84(3): 570 - 579. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. C. Oh, S. A. A. Beresford, and W. E. Lafferty The Fish in Secondary Prevention of Heart Disease (FISH) Survey--Primary Care Physicians and {omega}3 Fatty Acid Prescribing Behaviors J Am Board Fam Med, September 1, 2006; 19(5): 459 - 467. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Writing Committee Members, D. P. Zipes, A. J. Camm, M. Borggrefe, A. E. Buxton, B. Chaitman, M. Fromer, G. Gregoratos, G. Klein, A. J. Moss, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: A report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 746 - 837. [Full Text] [PDF]
|
|
|
|
 |
|
 M. Fisher, K. Lees, and J. D. Spence Nutrition and Stroke Prevention Stroke, September 1, 2006; 37(9): 2430 - 2435. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. G.E. Zarraga and E. R. Schwarz Impact of Dietary Patterns and Interventions on Cardiovascular Health Circulation, August 29, 2006; 114(9): 961 - 973. [Full Text] [PDF]
|
|
|
|
|
|
D. Giugliano, A. Ceriello, and K. Esposito The Effects of Diet on Inflammation: Emphasis on the Metabolic Syndrome J. Am. Coll. Cardiol., August 15, 2006; 48(4): 677 - 685. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Lee, K. M. Gura, S. Kim, D. A. Arsenault, B. R. Bistrian, and M. Puder Current Clinical Applications of {Omega}-6 and {Omega}-3 Fatty Acids Nutr Clin Pract, August 1, 2006; 21(4): 323 - 341. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Erdmann, N. Grosser, K. Schipporeit, and H. Schroder The ACE Inhibitory Dipeptide Met-Tyr Diminishes Free Radical Formation in Human Endothelial Cells via Induction of Heme Oxygenase-1 and Ferritin J. Nutr., August 1, 2006; 136(8): 2148 - 2152. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. Mittleman A 39-year-old woman with hypercholesterolemia. JAMA, July 19, 2006; 296(3): 319 - 326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E. Chiuve, M. L. McCullough, F. M. Sacks, and E. B. Rimm Healthy Lifestyle Factors in the Primary Prevention of Coronary Heart Disease Among Men: Benefits Among Users and Nonusers of Lipid-Lowering and Antihypertensive Medications Circulation, July 11, 2006; 114(2): 160 - 167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Wang, W. S Harris, M. Chung, A. H Lichtenstein, E. M Balk, B. Kupelnick, H. S Jordan, and J. Lau n-3 Fatty acids from fish or fish-oil supplements, but not {alpha}-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review Am. J. Clinical Nutrition, July 1, 2006; 84(1): 5 - 17. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Pignone Low-Total-Fat Diet Did Not Reduce the Risk of Cardiovascular Events Clin. Diabetes, July 1, 2006; 24(3): 143 - 144. [Full Text] [PDF]
|
|
|
|
|
|
K. Dalziel, L. Segal, and M. de Lorgeril A Mediterranean Diet Is Cost-Effective in Patients with Previous Myocardial Infarction J. Nutr., July 1, 2006; 136(7): 1879 - 1885. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Giugliano and K. Esposito Statins, diet, and low cholesterol. JAMA, June 7, 2006; 295(21): 2479 - 2479. [Full Text] [PDF]
|
|
|
|
|
|
J. L Breslow n-3 Fatty acids and cardiovascular disease Am. J. Clinical Nutrition, June 1, 2006; 83(6): S1477 - 1482S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. R Hibbeln, L. R. Nieminen, T. L Blasbalg, J. A Riggs, and W. E. Lands Healthy intakes of n-3 and n-6 fatty acids: estimations considering worldwide diversity Am. J. Clinical Nutrition, June 1, 2006; 83(6): S1483 - 1493S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. A Carpentier, L. Portois, and W. J Malaisse n-3 Fatty acids and the metabolic syndrome Am. J. Clinical Nutrition, June 1, 2006; 83(6): S1499 - 1504S. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. K Gebauer, T. L Psota, W. S Harris, and P. M Kris-Etherton n-3 Fatty acid dietary recommendations and food sources to achieve essentiality and cardiovascular benefits Am. J. Clinical Nutrition, June 1, 2006; 83(6): S1526 - 1535S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. A. Bischoff, H. B. Staehelin, and W. C. Willett The effect of undernutrition in the development of frailty in older persons. J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2006; 61(6): 585 - 589. [Full Text] [PDF]
|
|
|
|
 |
|
 A. Basu, S. Devaraj, and I. Jialal Dietary Factors That Promote or Retard Inflammation Arterioscler. Thromb. Vasc. Biol., May 1, 2006; 26(5): 995 - 1001. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Twardella, H Merx, H Hahmann, B Wusten, D Rothenbacher, and H Brenner Long term adherence to dietary recommendations after inpatient rehabilitation: prospective follow up study of patients with coronary heart disease Heart, May 1, 2006; 92(5): 635 - 640. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. W. Stone and H. D. Aronow Long-term Care After Percutaneous Coronary Intervention: Focus on the Role of Antiplatelet Therapy Mayo Clin. Proc., May 1, 2006; 81(5): 641 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A Mares and S. M Moeller Diet and age-related macular degeneration: expanding our view. Am. J. Clinical Nutrition, April 1, 2006; 83(4): 733 - 734. [Full Text] [PDF]
|
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||