European journal of preventive cardiology最新文献

Aims: The Planetary Health Diet Index (PHDI) prioritizes the well-being of both individuals and the planet but has yielded mixed results on cardiovascular disease (CVD). The aim of this study was to assess the association between the PHDI and risk of CVD.

Methods and results: A cohort of 118 469 individuals aged 40-69 years from the UK Biobank, who were free of CVD at 2009-12 and followed up to 2021. The PHDI was calculated using at least two 24-h dietary assessments and included 14 food groups, with a possible range from 0 to 130 points. Cardiovascular disease incidence was defined as primary myocardial infarction or stroke and obtained from clinical records and death registries. During a 9.4-year follow-up, 5257 incident cases of CVD were ascertained. When comparing the highest (89.9-128.5 points) vs. the lowest (21.1-71.1 points) quartile of PHDI adherence, the multivariable-adjusted hazard ratio [95% confidence interval (CI)] was 0.86 (0.79, 0.94) for CVD, 0.88 (0.80, 0.97) for myocardial infarction, and 0.82 (0.70, 0.97) for stroke. The association was linear until a plateau effect was reached at 80 points of adherence to PHDI. Results remained robust when excluding participants with type 2 diabetes, including only those with three or more diet assessments, or excluding CVD cases in the first 3 years of follow-up. The food group components of the PHDI more strongly associated with a reduced CVD risk were higher consumption of whole grains, whole fruits, and fish and lower consumption of added sugars and fruit juices.

Conclusion: In this large cohort of middle-aged and older British adults, adherence to the PHDI was associated with a lower risk of CVD. These results provide empirical evidence that this dietary pattern, thought to be environmentally sustainable, benefits cardiovascular health.

Aims: Erythritol, a sugar alcohol (polyol), has recently been linked to the risk of major adverse cardiovascular events. We investigated whether plasma erythritol and other polyols (mannitol/sorbitol) were associated with the risk of incident coronary heart disease (CHD).

Methods and results: This prospective nested case-control study included 762 incident cases of CHD and 762 controls from the Nurses' Health Study. Plasma concentrations of polyols were measured at baseline (1989-90 or 2000-02). Associations of erythritol with cardiometabolic risk factors were also analysed in the Women's Lifestyle Validation Study (n = 728; blood collected in 2010-12). Higher erythritol levels were related to more adverse cardiometabolic risk factor status. A relative risk (RR) for CHD per 1-SD increment was 1.15 [95% confidence interval (CI): 1.04, 1.28] for erythritol and 1.16 (95% CI: 1.05, 1.28) for mannitol/sorbitol, after adjusting for diet quality, lifestyles, and adiposity. Compared with women in the lowest quartile, those in the highest quartile (Q4) of erythritol had an RR of 1.55 (95% CI: 1.13, 2.14) for CHD. The RR in the Q4 of erythritol was 1.61 (95% CI: 1.15, 2.24; P = 0.006) when hypertension and dyslipidaemia were further added to the model; the RR was 1.21 (95% CI: 0.86, 1.70) after adjustment for diabetes. For mannitol/sorbitol, the RR in Q4 was 1.42 (95% CI: 1.05, 1.91; P = 0.022) for CHD in the multivariable-adjusted model including diabetes.

Conclusion: Higher levels of plasma erythritol and mannitol/sorbitol were related to elevated risks of CHD even after adjustment for diet, lifestyles, adiposity, and other risk factors. The unfavourable association of mannitol/sorbitol, but not of erythritol, with CHD risk remained significant independent of diabetes/hyperglycaemia.

Aims: Numerous studies have shown inverse associations between serum magnesium (Mg) and risk of cardiovascular disease (CVD), but studies of dietary Mg have not been consistent. To examine the association of a Mg-rich diet score with risks of CVD, coronary heart disease (CHD), and ischaemic stroke in the Atherosclerosis Risk in Communities (ARIC) study.

Methods and results: There were 15 022 Black and White adults without prevalent CVD at baseline (1987-89) included in this analysis. Diet was assessed at two visits 6 years apart using an interviewer-administered 66-item food frequency questionnaire. A Mg-rich diet score was created that included servings of whole grain products, nuts, vegetables, fruit, legumes, coffee, and tea. Cox proportional hazard regression evaluated associations of incident CVD, CHD, and stroke across quintiles of Mg-rich diet score, adjusting for demographics, lifestyle factors, and clinical characteristics. Over >30 years of follow-up, there were 3531 incident CVD events (2562 CHD, 1332 ischaemic stroke). Participants who consumed more Mg-rich foods were older, female, White, had lower blood pressure, fewer were not current smokers, and more reported being physically active. A Mg-rich diet was inversely associated with incident CVD (HRQ5 vs. Q1 = 0.87, 95% CI: 0.77-0.98, Ptrend = 0.02) and CHD (HRQ5 vs. Q1 = 0.82, 95% CI: 0.71-0.95, Ptrend = 0.01); however, the diet-stroke association was null (HRQ5 vs. Q1 = 1.00, 95% CI: 0.82-1.22, Ptrend = 0.97).

Conclusion: Consuming a diet including Mg-rich foods, such as whole grains, nuts, vegetables, fruits, legumes, coffee, and tea, is associated with lower risk of CVD and CHD, but not ischaemic stroke.

Aims: The benefits of achieving optimal cardiovascular health (CVH) through Life's Simple 7 (LS7) are well-documented across diverse populations. In this study, we assess the updated metrics, Life's Essential 8 (LE8), and its association with long-term cardiovascular disease (CVD) outcomes and mortality.

Methods and results: We conducted a comprehensive systematic review, searching PubMed, Google Scholar, Cochrane Library, and ScienceDirect from January 2022 until June 2024, focusing on studies that specifically assessed the impact of LE8 on CVH. The statistical analysis used RevMan 5.4 and applied a random effects model to synthesize hazard ratios (HRs) for primary and secondary outcomes. This study is registered in PROSPERO (CRD42024558493). Our final analysis comprised 34 observational studies, encompassing 1 786 664 participants aged 18-80 years, with an average follow-up of approximately 11.6 years. Pooled analysis revealed a statistically significant decrease in the risk of CVD among individuals with higher LE8 scores compared with those with lower scores, with an HR of 0.47 (95% CI: 0.39-0.56, P < 0.00001). Higher LE8 scores were also associated with significant reductions in both all-cause mortality (HR: 0.54, 95% CI: 0.43-0.69, P < 0.00001) and CVD-related mortality (HR: 0.37, 95% CI: 0.26-0.52, P < 0.00001. Moreover, individuals with high LE8 scores have a 56% lower risk of coronary heart disease and a 48% lower risk of stroke.

Conclusion: LE8 has a strong inverse association with CVD risk and mortality, with higher LE8 scores corresponding to significantly lower risk levels.