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Mediterranean and DASH diet scores and mortality in women with heart failure: The Women's Health Initiative.

Abstract

BACKGROUND

Current dietary recommendations for patients with heart failure (HF) are largely based on data from non-HF populations; evidence on associations of dietary patterns with outcomes in HF is limited. We therefore evaluated associations of Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet scores with mortality among postmenopausal women with HF.

METHODS AND RESULTS

Women's Health Initiative participants were followed up from the date of HF hospitalization through the date of death or last participant contact before August 2009. Mediterranean and DASH diet scores were calculated from food-frequency questionnaires. Cox proportional hazards models adjusted for demographics, health behaviors, and health status were used to calculate hazard ratios and 95% confidence intervals (CI). For a median of 4.6 years of follow-up, 1385 of 3215 (43.1%) participants who experienced a HF hospitalization died. Multivariable-adjusted hazard ratios were 1 (reference), 1.05 (95% CI, 0.89-1.24), 0.97 (95% CI, 0.81-1.17), and 0.85 (95% CI, 0.70-1.02) across quartiles of the Mediterranean diet score (P trend=0.08) and 1 (reference), 1.04 (95% CI, 0.89-1.21), 0.83 (95% CI, 0.70-0.98), and 0.84 (95% CI, 0.70-1.00) across quartiles of the DASH diet score (P trend=0.01). Diet score components, vegetables, nuts, and whole grain intake, were inversely associated with mortality.

CONCLUSIONS

Higher DASH diet scores were associated with modestly lower mortality in women with HF, and there was a nonsignificant trend toward an inverse association with Mediterranean diet scores. These data provide support for the concept that dietary recommendations developed for other cardiovascular conditions or general populations may also be appropriate in patients with HF.

CLINICAL TRIAL REGISTRATION

URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000611.

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  • Authors+Show Affiliations

    ,

    University of Alabama at Birmingham.

    , , , , , , , , ,

    Source

    Circulation. Heart failure 6:6 2013 Nov pg 1116-23

    MeSH

    Aged
    Confidence Intervals
    Diet, Mediterranean
    Female
    Heart Failure
    Humans
    Middle Aged
    Proportional Hazards Models
    Retrospective Studies
    Risk Factors
    Survival Rate
    United States
    Women's Health

    Pub Type(s)

    Journal Article
    Multicenter Study
    Randomized Controlled Trial
    Research Support, N.I.H., Extramural

    Language

    eng

    PubMed ID

    24107587

    Citation

    Levitan, Emily B., et al. "Mediterranean and DASH Diet Scores and Mortality in Women With Heart Failure: the Women's Health Initiative." Circulation. Heart Failure, vol. 6, no. 6, 2013, pp. 1116-23.
    Levitan EB, Lewis CE, Tinker LF, et al. Mediterranean and DASH diet scores and mortality in women with heart failure: The Women's Health Initiative. Circ Heart Fail. 2013;6(6):1116-23.
    Levitan, E. B., Lewis, C. E., Tinker, L. F., Eaton, C. B., Ahmed, A., Manson, J. E., ... Shikany, J. M. (2013). Mediterranean and DASH diet scores and mortality in women with heart failure: The Women's Health Initiative. Circulation. Heart Failure, 6(6), pp. 1116-23. doi:10.1161/CIRCHEARTFAILURE.113.000495.
    Levitan EB, et al. Mediterranean and DASH Diet Scores and Mortality in Women With Heart Failure: the Women's Health Initiative. Circ Heart Fail. 2013;6(6):1116-23. PubMed PMID: 24107587.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Mediterranean and DASH diet scores and mortality in women with heart failure: The Women's Health Initiative. AU - Levitan,Emily B, AU - Lewis,Cora E, AU - Tinker,Lesley F, AU - Eaton,Charles B, AU - Ahmed,Ali, AU - Manson,JoAnn E, AU - Snetselaar,Linda G, AU - Martin,Lisa W, AU - Trevisan,Maurizio, AU - Howard,Barbara V, AU - Shikany,James M, Y1 - 2013/10/09/ PY - 2013/10/11/entrez PY - 2013/10/11/pubmed PY - 2014/1/23/medline KW - diet KW - heart failure KW - mortality KW - nutrition SP - 1116 EP - 23 JF - Circulation. Heart failure JO - Circ Heart Fail VL - 6 IS - 6 N2 - BACKGROUND: Current dietary recommendations for patients with heart failure (HF) are largely based on data from non-HF populations; evidence on associations of dietary patterns with outcomes in HF is limited. We therefore evaluated associations of Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet scores with mortality among postmenopausal women with HF. METHODS AND RESULTS: Women's Health Initiative participants were followed up from the date of HF hospitalization through the date of death or last participant contact before August 2009. Mediterranean and DASH diet scores were calculated from food-frequency questionnaires. Cox proportional hazards models adjusted for demographics, health behaviors, and health status were used to calculate hazard ratios and 95% confidence intervals (CI). For a median of 4.6 years of follow-up, 1385 of 3215 (43.1%) participants who experienced a HF hospitalization died. Multivariable-adjusted hazard ratios were 1 (reference), 1.05 (95% CI, 0.89-1.24), 0.97 (95% CI, 0.81-1.17), and 0.85 (95% CI, 0.70-1.02) across quartiles of the Mediterranean diet score (P trend=0.08) and 1 (reference), 1.04 (95% CI, 0.89-1.21), 0.83 (95% CI, 0.70-0.98), and 0.84 (95% CI, 0.70-1.00) across quartiles of the DASH diet score (P trend=0.01). Diet score components, vegetables, nuts, and whole grain intake, were inversely associated with mortality. CONCLUSIONS: Higher DASH diet scores were associated with modestly lower mortality in women with HF, and there was a nonsignificant trend toward an inverse association with Mediterranean diet scores. These data provide support for the concept that dietary recommendations developed for other cardiovascular conditions or general populations may also be appropriate in patients with HF. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000611. SN - 1941-3297 UR - https://www.unboundmedicine.com/medline/citation/24107587/full_citation L2 - http://www.ahajournals.org/doi/full/10.1161/CIRCHEARTFAILURE.113.000495?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -