Arginine intake and risk of coronary heart disease mortality in elderly men

From experimental studies, the hypothesis is derived that the amino acid arginine, the precursor of NO, could restore the impaired endothelial function and increased platelet activation observed in atherosclerosis. We investigated whether dietary intake of arginine is associated with reduced coronary heart disease risk in elderly persons. The study population consisted of 806 men aged 64 to 84 years at baseline who participated in the Zutphen Elderly Study, a population-based cohort followed up for 10 years. Information about habitual food consumption was collected by use of the cross-check dietary history method. Ninety (11.2%) of the 806 men died from coronary heart disease. Mean+/-SD baseline arginine intake was 4. 35+/-1.07 g/d. Meat was the main source of arginine intake (37.1%), followed by bread (13.1%) and milk and milk products (12.1%). Arginine intake was not associated with coronary heart disease mortality. After adjustment for age, the relative risk (RR) for the medium tertile of arginine intake was 0.72 (95% CI 0.44 to 1.18), and the RR for the highest tertile was 0.71 (95% CI 0.43 to 1.19, P: for trend=0.19) compared with the lowest tertile of arginine intake. After additional adjustment for history of coronary heart disease and diabetes mellitus, energy intake, body mass index, smoking habit, physical activity, and other relevant dietary and biological risk factors, the RR was 1.86 (95% CI 1.06 to 3.27) for the medium intake and 1.56 (95% CI 0.83 to 2.93) for the highest intake (P: for trend=0.17). These results do not support the hypothesis that dietary arginine intake lowers the risk of coronary heart disease mortality.     

Flavonols intake and the risk of coronary heart disease: a meta-analysis of cohort studies

ObjectiveProspective cohort are inconsistent regarding the association between flavonols intake and the risk of coronary heart disease (CHD). The aim was to perform a meta-analysis to determine whether an association exists between them in observational studies.MethodsWe searched PUBMED and EMBASE databases for studies conducted from 1966 through January 2012. Data were independently abstracted by 2 investigators using a standardized protocol. Study-specific risk estimates were combined by using a random-effects model.ResultsA total of nine general population cohorts with 216,908 participants and more than 5249 CHD cases were included in the meta-analysis. The summary relative risk (RR) did not indicate a significant association between the highest flavonols intake and reduced risk of CHD (summary RR: 0.91; 95% CI: 0.83, 1.01). Furthermore, no significant association was found through the dose-response analysis (an increment of 20 mg/day, summary RR: 0.96; 95% CI: 0.90, 1.03).ConclusionsOur results do not support a protective role of flavonols intake against CHD.     

Is low energy intake a risk factor for ischaemic heart disease?

The relation between total energy intake and the development of ischaemic heart disease was investigated from a review of all available data including the results of 26 years of follow up from a longitudinal study of diet and ischaemic heart disease. A consistent inverse relation was found, whose strength and consistency are similar to those of other established risk factors. It is concluded that there may be a minimum energy intake below which the risk of ischaemic heart disease is increased.     

Is low energy intake a risk factor for ischaemic heart disease?

The relation between total energy intake and the development of ischaemic heart disease was investigated from a review of all available data including the results of 26 years of follow up from a longitudinal study of diet and ischaemic heart disease. A consistent inverse relation was found, whose strength and consistency are similar to those of other established risk factors. It is concluded that there may be a minimum energy intake below which the risk of ischaemic heart disease is increased.     

Antioxidant vitamins intake and the risk of coronary heart disease: meta-analysis of cohort studies.

BACKGROUND: Many epidemiological studies have reported that antioxidant vitamin intake from diet or supplements are associated with a lower risk of coronary heart disease (CHD), the findings are, however, inconsistent. We undertook a meta-analysis of cohort studies to examine the relations between antioxidant vitamins (vitamins C, E, and beta-carotene) and CHD risk. METHODS AND RESULTS: We included all the relevant cohort studies if they provided a relative risk and corresponding 95% confidence interval (CI) of CHD in relation to antioxidant vitamins intake from diet or supplement. Fifteen cohort studies were identified involving a total of 7415 incident CHD cases and 374,488 participants with a median follow-up of approximately 10, 8.5, and 15 years for vitamins C, E, and beta-carotene, respectively. Pooled estimates across studies were obtained by random-effects model. The potential sources of heterogeneity and publication bias were also estimated. For vitamins C, E, and beta-carotene, a comparison of individuals in the top third with those in the bottom third of baseline value yielded a combined relative risk of 0.84 (95% CI, 0.73-0.95), 0.76 (95% CI, 0.63-0.89), and 0.78 (95% CI, 0.53-1.04), respectively. Subgroup analyses show that dietary intake of vitamins C and E and supplement use of vitamin E have an inverse association with CHD risk, but supplement use of vitamin C has no significant association with CHD risk. In the dose-response meta-analysis, each 30 mg/day increase in vitamin C, 30 IU/day increase in vitamin E, and 1 mg/day increase in beta-carotene yielded the estimated overall relative risk for CHD of 1.01 (95% CI, 0.99-1.02), 0.96 (95% CI, 0.94-0.99), and 1.00 (95% CI, 0.88-1.14), respectively. CONCLUSIONS: Our findings in this meta-analysis suggest that an increase in dietary intake of antioxidant vitamins has encouraging prospects for possible CHD prevention.     

The effect of fruit and vegetable intake on risk for coronary heart disease.

BACKGROUND: Many constituents of fruits and vegetables may reduce the risk for coronary heart disease, but data on the relationship between fruit and vegetable consumption and risk for coronary heart disease are sparse. OBJECTIVE: To evaluate the association of fruit and vegetable consumption with risk for coronary heart disease. DESIGN: Prospective cohort study. SETTING: The Nurses' Health Study and the Health Professionals' Follow-Up Study. PARTICIPANTS: 84 251 women 34 to 59 years of age who were followed for 14 years and 42 148 men 40 to 75 years who were followed for 8 years. All were free of diagnosed cardiovascular disease, cancer, and diabetes at baseline. MEASUREMENTS: The main outcome measure was incidence of nonfatal myocardial infarction or fatal coronary heart disease (1127 cases in women and 1063 cases in men). Diet was assessed by using food-frequency questionnaires. RESULTS: After adjustment for standard cardiovascular risk factors, persons in the highest quintile of fruit and vegetable intake had a relative risk for coronary heart disease of 0.80 (95% CI, 0.69 to 0.93) compared with those in the lowest quintile of intake. Each 1-serving/d increase in intake of fruits or vegetables was associated with a 4% lower risk for coronary heart disease (relative risk, 0.96 [CI, 0.94 to 0.99]; P = 0.01, test for trend). Green leafy vegetables (relative risk with 1-serving/d increase, 0.77 [CI, 0.64 to 0.93]), and vitamin C-rich fruits and vegetables (relative risk with 1-serving/d increase, 0.94 [CI, 0.88 to 0.99]) contributed most to the apparent protective effect of total fruit and vegetable intake. CONCLUSIONS: Consumption of fruits and vegetables, particularly green leafy vegetables and vitamin C-rich fruits and vegetables, appears to have a protective effect against coronary heart disease.     

Dietary magnesium intake and the future risk of coronary heart disease (the Honolulu Heart Program)

Magnesium (Mg) deficiency is believed to have adverse cardiovascular consequences that are broad and complex, although an association between dietary Mg intake and the risk of coronary heart disease (CHD) has not been clearly identified. The purpose of this study is to examine the relation between dietary Mg intake and future risk of CHD. Reported findings are based on dietary Mg intake in 7,172 men in the Honolulu Heart Program. Intake of Mg was recorded at baseline examinations that took place from 1965 to 1968 when the men were aged 45 to 68 years. In 30 years of follow-up, 1,431 incident cases of CHD were identified. Within 15 years after dietary assessment, the age-adjusted incidence decreased significantly from 7.3 to 4.0 per 1,000 person-years in the lowest (50.3 to 186 mg/day) versus highest (340 to 1,183 mg/day) quintiles of Mg intake (p <0.001). When adjustments were made for age and other nutrients (singly or combined), there was a 1.7- to 2.1-fold excess in the risk of CHD in the lowest versus highest quintiles (p <0.001). The excess risk ranged from 1.5- to 1.8-fold after further adjustment for other cardiovascular risk factors (p <0.05). Associations between dietary Mg and coronary events occurring after 15 years of follow-up were modest. We conclude that the intake of dietary Mg is associated with a reduced risk of CHD. Whether increases in dietary Mg intake can alter the future risk of disease warrants further study.     

Parental death from heart disease and the risk of heart attack

In the British Regional Heart Study, 7735 men aged 40–59years were asked at initial screening whether their father ormother was alive or dead and to what cause any death had beenattributed. They were followed up for the occurrence of majorischaemic heart disease events. At screening the men reportedthat 23% of the fathers and 43% of the mothers were alive andthat 19% of the fathers and 11% of the mothers had died of hearttrouble. In a sample of parental deaths, the death certificatewas obtained and it was found that a son's report of a parentaldeath from ’heart trouble‘ was a reliable indicationthat death had been certified to ischaemic heart disease. However,about half of the parental deaths certified as ischaemic heartdisease were not reported as ‘heart trouble’ bytheir sons. A major ischaemic heart disease event was experienced by 336men over an average follow-up of 6.2 years. Men who said theirfather had died from ‘heart trouble’ were at twicethe risk of a major ischaemic heart disease event compared withmen whose fathers were still alive and 1.5 times the risk ofmen who reported their father to be dead from another or unknowncause, even after accounting for age, systolic blood pressure,serum total cholesterol, cigarette smoking and serum HDL-cholesterol.For men with mother dead from heart trouble, the correspondingfigures were 1.3 and 10. The results are consistent with those from other prospectivestudies in indicating that men with a parental history of ischaemicheart disease are at increased risk of a heart attack and thatonly a small proportion of this excess risk is explained byincreased levels of the risk factors at screening. There appearsto be a familial risk factor, environmental or genetic, expressedby parental death from heart disease, which merits further investigationby detailed family studies of ischaemic heart disease.     

Psychosocial risk factors and heart disease

Despite the evidence linking psychosocial risk factors and heart disease, most patients choose the combination of steak, statins,and stents over psychotherapy to change their lifestyle.     

Hypertriglyceridemia and risk of coronary heart disease

Mounting evidence indicates that elevated triglyceride level is a risk factor for coronary heart disease (CHD). The role of triglyceride as a causative agent for CHD is less clear. Hyper-triglyceridemia is frequently associated with a set of complex metabolic abnormalities, including low high-density lipoprotein cholesterol, small dense low-density lipoprotein, central obesity, insulin resistance, and type 2 diabetes. Understanding the physiologic processes that lead to the metabolic disturbances associated with hypertriglyceridemia is essential in investigating the effect of triglyceride on CHD risk.     

膳食中抗氧化维生素摄入量与冠心病事件发病率的关系

目的 探讨不同人群平均胡萝卜素及其他抗氧化素的摄入量与冠心病事件发病率的关系。方法 在我国１３个人群中进行心血管病发病监测,并在抽样人群中进行了心血管病危险因素调查（包括膳食调查）结果 各人群胡萝卜素的平均摄入量（男性４２１～１４１６μｇ／１０００Ｋｃａｌ,女性５７３～２１１４μｇ／１０００Ｋｃａｌ）与冠心病事件标化发病率（男性１／１０万,女性０／１０万至７７／１０万）呈显负相关（ｒ＝－０．４２