Dietary Predictors of Congestive Heart Failure

描述（由申请人提供）：充血性心力衰竭（CHF）是65岁及以上美国人中最常见的住院原因。由于人口老龄化和心肌梗死后生存率的提高，CHF的发病率和流行率正在增加。饮食模式和食物选择可能通过心肌梗死、高血压和糖尿病或更微妙的代谢紊乱影响CHF的风险。饮食干预有可能增强目前可用的行为和药理学预防策略，但目前对饮食和CHF之间的关系知之甚少。我们提出了关于饮食模式和CHF的三个假设：1)坚持DASH饮食会降低女性和男性CHF的发病率；2)食用富含脂肪的鱼类、总omega-3多不饱和脂肪酸以及海洋和植物来源的omega-3多不饱和脂肪酸会降低女性和男性CHF的发病率；omega-6与omega-3的比例越高，风险越高；3)较高的膳食血糖指数和膳食血糖负荷与女性发生CHF的风险增加有关。为了评估这些假设，我们将在两个特征明确的队列背景下进行前瞻性研究：瑞典乳房x线摄影队列超过36,000名女性和瑞典男性队列包括超过45,000名男性。在这些队列中，使用经过验证的食物频率问卷来测量饮食。从1998年1月1日至2003年12月31日，通过瑞典住院患者和死亡原因登记册对因瑞士心力衰竭而首次住院或因瑞士心力衰竭而死亡的个体进行了跟踪，这一诊断已被证明具有很高的有效性。我们将使用比例风险模型来计算与饮食模式相关的CHF发病率比。

DESCRIPTION (provided by applicant): Congestive heart failure (CHF) is the most common cause of hospitalization among Americans aged 65 and older. Incidence and prevalence of CHF are increasing because of aging of the population and increased survival following myocardial infarction. Diet patterns and food choices may influence risk of CHF through myocardial infarction, hypertension, and diabetes or through more subtle metabolic disturbances. Dietary interventions have the potential to augment currently available behavioral and pharmacologic CHF prevention strategies, but currently little is known about the relationship between diet and CHF. We have developed three hypotheses regarding diet patterns and CHF: 1) Adherence to the DASH diet will reduce incidence of CHF in women and men; 2) Consumption of fatty fish, total omega-3 polyunsaturated fatty acids, and marine and plant derived omega-3 polyunsaturated fatty acids will reduce incidence of CHF in women and men; higher omega-6 to omega-3 ratio will be associated with increased risk; and 3) Higher dietary glycemic index and dietary glycemic load will be associated with increased risk of CHF in women. To evaluate these hypotheses, we will conduct a prospective study in the context of two well-characterized cohorts: the Swedish Mammography Cohort of over 36,000 women and the Cohort of Swedish Men which includes over 45,000 men. In these cohorts, diet was measured using validated food-frequency questionnaires. Individuals were followed from January 1, 1998 to December 31, 2003 through the Swedish inpatient and cause-of-death registers for first hospitalization due to or death from CHF, a diagnosis that has been shown to have high validity. We will use proportional hazards models to calculate incidence rate ratios of CHF associated with the dietary patterns. Plain language summary: Congestive heart failure is a common and often deadly disease, particularly among older adults. Currently little is known about dietary causes of congestive heart failure. We will evaluate whether adherence to the DASH diet, fatty fish and polyunsaturated fatty acids, and dietary glycemic index and glycemic load affect risk of congestive heart failure in two large groups, 36,000 women in the Swedish Mammography Cohort and 45,000 men in the Cohort of Swedish Men.