Relationship Between a Plant-Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study.
Relationship Between a Plant-Based Dietary Portfolio and Risk of Cardiovascular Disease: Findings From the Women's Health Initiative Prospective Cohort Study.
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DOI：
10.1161/jaha.121.021515
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发表时间：
2021-08-17
影响因子：
5.4
通讯作者：
Sievenpiper JL
中科院分区：
文献类型：
--
作者：
Glenn AJ;Lo K;Jenkins DJA;Boucher BA;Hanley AJ;Kendall CWC;Manson JE;Vitolins MZ;Snetselaar LG;Liu S;Sievenpiper JL
以植物为基础的膳食组合结合了现有的降胆固醇食物（植物蛋白、坚果、粘性纤维和植物甾醇）以及单不饱和脂肪，并已被证明可以改善低密度脂蛋白胆固醇和其他心血管疾病 (CVD) 危险因素。尚无研究评估膳食组合与 CVD 事件的关系。从 1993 年到 2017 年，我们在妇女健康倡议中对 123,330 名最初没有 CVD 的绝经后妇女进行了跟踪。我们使用 Cox 比例风险模型来估计调整后的风险比 (HR) 和坚持组合饮食评分与 CVD 结果之间关系的 95% CI。主要结局是总心血管疾病、冠心病和中风。次要结局是心力衰竭和心房颤动。在平均 15.3 年的随访中，共发生 13,365 例 CVD、5640 例冠心病、4440 例中风、1907 例心力衰竭和 929 例心房颤动事件。经过多次调整后，比较最高四分位数与最低四分位数，坚持组合饮食评分与较低的总心血管疾病风险（HR，0.89；95% CI，0.83–0.94）、冠心病（HR，0.86；95% CI，0.78–0.95）和心力衰竭（HR，0.83；95% CI，0.71–0.99）风险相关的坚持。与卒中（HR，0.97；95% CI，0.87-1.08）或心房颤动（HR，1.10；95% CI，0.87-1.38）无关。经过多次敏感性分析后，这些结果仍然具有统计学意义。在美国绝经后妇女的这一前瞻性队列中，对组合饮食的较高依从性与心血管和冠状动脉事件以及心力衰竭事件的减少有关。这些发现值得在其他人群中进行进一步研究。
The plant‐based Dietary Portfolio combines established cholesterol‐lowering foods (plant protein, nuts, viscous fiber, and phytosterols), plus monounsaturated fat, and has been shown to improve low‐density lipoprotein cholesterol and other cardiovascular disease (CVD) risk factors. No studies have evaluated the relation of the Dietary Portfolio with incident CVD events. We followed 123 330 postmenopausal women initially free of CVD in the Women's Health Initiative from 1993 through 2017. We used Cox proportional‐hazard models to estimate adjusted hazard ratios (HRs) and 95% CI of the association of adherence to a Portfolio Diet score with CVD outcomes. Primary outcomes were total CVD, coronary heart disease, and stroke. Secondary outcomes were heart failure and atrial fibrillation. Over a mean follow‐up of 15.3 years, 13 365 total CVD, 5640 coronary heart disease, 4440 strokes, 1907 heart failure, and 929 atrial fibrillation events occurred. After multiple adjustments, adherence to the Portfolio Diet score was associated with lower risk of total CVD (HR, 0.89; 95% CI, 0.83–0.94), coronary heart disease (HR, 0.86; 95% CI, 0.78–0.95), and heart failure (HR, 0.83; 95% CI, 0.71–0.99), comparing the highest to lowest quartile of adherence. There was no association with stroke (HR, 0.97; 95% CI, 0.87–1.08) or atrial fibrillation (HR, 1.10; 95% CI, 0.87–1.38). These results remained statistically significant after several sensitivity analyses. In this prospective cohort of postmenopausal women in the United States, higher adherence to the Portfolio Diet was associated with a reduction in incident cardiovascular and coronary events, as well as heart failure. These findings warrant further investigation in other populations.