Effects of Diet on 10-Year Atherosclerotic Cardiovascular Disease Risk (from the DASH Trial).
Effects of Diet on 10-Year Atherosclerotic Cardiovascular Disease Risk (from the DASH Trial).
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DOI：
10.1016/j.amjcard.2022.10.019
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发表时间：
2023-01-15
影响因子：
2.8
通讯作者：
Juraschek, Stephen P.
中科院分区：
文献类型：
--
作者：
Jeong, Sun Young;Wee, Christina C.;Kovell, Lara C.;Plante, Timothy B.;Miller, Edgar R.;Appel, Lawrence J.;Mukamal, Kenneth J.;Juraschek, Stephen P.
尽管现代风险评估方法，如美国心脏病学会/美国心脏协会汇总队列方程，在患者是否开始药物治疗以预防动脉粥样硬化性心血管疾病（ASCVD）的决定中发挥了核心作用，但现有的生活方式干预措施对10年ASCVD风险降低的预期证据有限。使用原始DASH（饮食方法来阻止高血压）试验的数据，我们确定采用DASH饮食与采用对照或水果和蔬菜（F/V）饮食相比，对10年ASCVD风险的影响。DASH试验包括459名年龄在22至75岁之间、无心血管疾病且未服用抗高血压或糖尿病药物的成年人，他们被随机分为对照饮食、F/V饮食或DASH饮食，为期8周。我们根据8周干预前后测量的血压和血脂，使用美国心脏病学会/美国心脏协会合并队列方程确定10年ASCVD风险。与对照饮食相比，DASH和F/V饮食使10年ASCVD风险分别降低了- 10.3%（95%可信区间[CI] - 14.4至- 5.9）和- 9.9% (95% CI - 14.0至- 5.5)；这些影响在女性和黑人成年人中更为明显。DASH和F/V饮食之间没有差异（-0.4%,95% CI - 6.9至6.5）。仅收缩压差异导致的ASCVD降低，DASH饮食组为- 14.6%(-17.3至- 11.7)，F/V饮食组为- 7.9%(- 10.9至- 4.8)，与F/V饮食组相比，DASH饮食组相对降低的净相对优势为7.2%。这被DASH饮食对高密度脂蛋白的影响所抵消，DASH饮食使10年ASCVD增加8.8%(5.5至12.3)，而F/V饮食的影响更为中性，为- 1.9%（- 5.0至1.2）。总之，与典型的美国饮食相比，DASH和F/V饮食在8周内将10年ASCVD风险评分降低了约10%。这些发现对患者的饮食选择和10年ASCVD风险降低的预期提供了信息。
Although modern risk estimators, such as the American College of Cardiology/American Heart Association Pooled Cohort Equation, play a central role in the decisions of patients to start pharmacologic therapy to prevent atherosclerotic cardiovascular disease (ASCVD), there is limited evidence to inform expectations for 10-year ASCVD risk reduction from established lifestyle interventions. Using data from the original DASH (Dietary Approaches to Stop Hypertension) trial, we determined the effects of adopting the DASH diet on 10-year ASCVD risk compared with adopting a control or a fruits and vegetables (F/V) diet. The DASH trial included 459 adults aged 22 to 75 years without CVD and not taking antihypertensive or diabetes mellitus medications, who were randomized to controlled feeding of a control diet, an F/V diet, or the DASH diet for 8 weeks. We determined 10-year ASCVD risk with the American College of Cardiology/American Heart Association Pooled Cohort Equation based on blood pressure and lipids measured before and after the 8-week intervention. Compared with the control diet, the DASH and F/V diets changed 10-year ASCVD risk by −10.3% (95% confidence interval [CI] −14.4 to −5.9) and −9.9% (95% CI −14.0 to −5.5) respectively; these effects were more pronounced in women and Black adults. There was no difference between the DASH and F/V diets (–0.4%, 95% CI −6.9 to 6.5). ASCVD reductions attributable to the difference in systolic blood pressure alone were −14.6% (–17.3 to −11.7) with the DASH diet and −7.9% (−10.9 to −4.8) with the F/V diet, a net relative advantage of 7.2% greater relative reduction from DASH compared with F/V. This was offset by the effects on high-density lipoprotein of the DASH diet, which increased 10-year ASCVD by 8.8% (5.5 to 12.3) compared with the more neutral effect of the F/V diet of −1.9% (−5.0 to 1.2). In conclusion, compared with a typical American diet, the DASH and F/V diets reduced 10-year ASCVD risk scores by about 10% over 8 weeks. These findings are informative for counseling patients on both choices of diet and expectations for 10-year ASCVD risk reduction.
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影响因子：
24
作者：
Anand SS;Hawkes C;de Souza RJ;Mente A;Dehghan M;Nugent R;Zulyniak MA;Weis T;Bernstein AM;Krauss RM;Kromhout D;Jenkins DJA;Malik V;Martinez-Gonzalez MA;Mozaffarian D;Yusuf S;Willett WC;Popkin BM
通讯作者：
Popkin BM
DOI：
10.1161/atvbaha.120.314609
发表时间：
2020-11
期刊：
Arteriosclerosis, thrombosis, and vascular biology
影响因子：
--
作者：
Sacks FM;Liang L;Furtado JD;Cai T;Davidson WS;He Z;McClelland RL;Rimm EB;Jensen MK
通讯作者：
Jensen MK
DOI：
10.1161/circoutcomes.109.930685
发表时间：
2010-09
期刊：
Circulation. Cardiovascular quality and outcomes
影响因子：
--
作者：
Chen ST;Maruthur NM;Appel LJ
通讯作者：
Appel LJ
高密度脂蛋白的心脏保护作用超出了其抗动脉粥样硬化作用。
影响因子：
4.4
作者：
Nagao M;Nakajima H;Toh R;Hirata KI;Ishida T
通讯作者：
Ishida T
影响因子：
5.6
作者：
Sacks, Frank M.;Obarzanek, Eva;Moore, Thomas J.
通讯作者：
Moore, Thomas J.