Dietary Patterns and Precision Prevention of Heart Failure.
Dietary Patterns and Precision Prevention of Heart Failure.
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饮食模式和心力衰竭的精准预防。
DOI：
10.1016/j.jacc.2019.02.037
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发表时间：
2019
影响因子：
24
通讯作者：
Wang,DongD
中科院分区：
文献类型：
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作者：
Wang,DongD
随着时间的推移，心力衰竭（HF）的患病率越来越高，目前在美国影响了650万成年人(1)。尽管在过去的几十年里，药物选择和器械改善了射血分数降低（HFrEF）的心衰患者的生存率，但通过保留射血分数（HFpEF）来控制心衰的策略却不太完善。考虑到HF治疗难度大、患者虚弱程度高、治疗费用高(2)，应优先考虑预防HF。虽然采用健康饮食被推荐为心衰的一级预防(1)，但来自流行病学研究的可支持这一建议的直接证据仍然有限。在这期杂志上，Lara等人(3)发表了一项前瞻性研究，在REGARDS（中风的地理和种族差异的原因）研究中，研究了主要饮食模式与心衰及其两种亚型HFpEF和HFrEF发病率的关系。作者从16,068名无冠心病（CHD）的黑人和白人成年人中得出了5种主要的饮食模式。他们报告说，坚持“植物性”饮食模式，多摄入水果、蔬菜、鱼、家禽和低脂乳制品，少喝苏打水，与HF的风险较低有关。这种关联独立于CVD的既定危险因素，并且在进一步调整潜在中介因素后几乎没有变化
Heart failure (HF), with an increasing prevalence over time, now affects> 6.5 million adults in the United States (1). Although pharmacological options and devices have improved survival of HF patients with reduced ejection fraction (HFrEF) in the past decades, strategies to control heart failure with preserved ejection fraction (HFpEF) are less well established. Considering the difficulty in treating HF, severe debility experienced by HF patients, and the high cost of HF care (2), prevention of HF should be prioritized. Although adopting a healthy diet is recommended for the primary prevention of HF (1), direct evidence from epidemiological studies that can underpin this recommendation is still limited.In this issue of the Journal, Lara et al.(3) present a prospective study that examined major dietary patterns in association with the incidence of HF and its 2 subtypes, HFpEF and HFrEF, in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study. The authors derived 5 major dietary patterns in 16,068 black and white adults who were free from coronary heart disease (CHD) at baseline. They report that a higher adherence to a “plant-based” dietary pattern, featuring high intakes of fruit, vegetables, fish, poultry, and low-fat dairy, and low consumption of soda, was associated with a lower risk of HF. This association was independent of established risk factors of CVD and barely changed after further adjusting for potential mediating factors, including measures of