Abstract 8968: Reduction of Non-hdl-cholesterol by More Than 5% with NCEP Diet Reduces CHD Risk
Background and aims: Dietary management is considered to be very important to lower plasma lipids. Non-HDL-cholesterol may be a better indicator of coronary heart disease (CHD) than traditional lipid risk markers (LDL-cholesterol, HDL-cholesterol), which was confirmed in previous studies. However the extent to which non-HDL-cholesterol must be lowered to decrease CHD risk with diet remains to be clarified. To answer this question, we conducted a post-hoc analysis of the dietary treatment group in a large-scale randomized primary prevention trial in Japanese.
Materials and methods 7832 patients with mild hypercholesterolemia were randomly allocated to either diet alone (n=3966) or diet+pravastatin (n=3866) and followed for an average of 5 years. The patients were instructed to follow the National Cholesterol Education Program (NCEP) guideline step 1 diet, which is low in cholesterol and saturated fats, with the addition of fish, like in the usual Japanese diet. Incidence rates of CHD, CHD+cerebral infarction (CI), and all cardiovascular events were calculated by the Cox proportional hazard model according to the reduction rates of non-HDL-cholesterol.
Results Baseline non-HDL-cholesterol level in the diet group was 184.4±18.6 mg/dL. CHD incidence was significantly reduced by 42% (p=0.02) and by 50% (p=0.007) in relation to a 3% and 5% lowering of non-HDL-cholesterol respectively. The total cardiovascular event rate was significantly reduced by 34% (p=0.02) with a 5% lowering of non-HDL-cholesterol. Neither stroke nor all-cause mortality was affected significantly. On treatment non-HDL-cholesterol levels were less than 174 mg/dL, indicating the reduction of CHD and cardiovascular events.
Conclusion A reduction of 5% or more of non-HDL-cholesterol with the modified NCEP step 1 diet was associated with a significant reduction in CHD and cardiovascular events.
- © 2011 by American Heart Association, Inc.