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Changes in ultrasound-assessed carotid intima-media thickness and plaque with a Mediterranean diet: a substudy of the PREDIMED trial.
Arterioscler Thromb Vasc Biol 2014; 34(2):439-45AT

Abstract

OBJECTIVE

The Prevención con Dieta Mediterránea (PREDIMED) trial showed that a Mediterranean diet (MedDiet) supplemented with either extra virgin olive oil or 30 g/d of mixed nuts reduced incident cardiovascular events compared with a control (low fat) diet. The mechanisms of cardiovascular protection afforded by MedDiets remain to be uncovered. We assessed the effect of both supplemented MedDiets on internal carotid intima-media thickness (ICA-IMT) and plaque height, the ultrasound features that best predict future cardiovascular events, in subjects at high cardiovascular risk.

APPROACH AND RESULTS

In a PREDIMED subcohort (n=175), plaque height and carotid IMT of 3 prespecified segments (ICA, bifurcation, and common) were sonographically assessed at baseline and after intervention for a mean of 2.4 years. We evaluated 164 subjects with complete data. In a multivariate model, mean ICA-IMT progressed in the control diet group (mean [95% confidence interval], 0.052 mm [-0.014 to 0.118 mm]), whereas it regressed in the MedDiet+nuts group (-0.084 mm [-0.158 to -0.010 mm]; P=0.024 versus control). Similar results were observed for maximum ICA-IMT (control, 0.188 mm [0.077 to 0.299 mm]; MedDiet+nuts, -0.030 mm [-0.153 to 0.093 mm]; P=0.034) and maximum plaque height (control, 0.106 mm [0.001 to 0.210 mm]; MedDiet+nuts, -0.091 mm [-0.206 to 0.023 mm]; P=0.047). There were no changes in ICA-IMT or plaque after the MedDiet+extra virgin olive oil.

CONCLUSIONS

Compared with a control diet, consumption of a MedDiet supplemented with nuts is associated with delayed progression of ICA-IMT and plaque. The results contribute mechanistic evidence for the reduction of cardiovascular events observed in the PREDIMED trial.

CLINICAL TRIAL REGISTRATION URL

http://www.controlled-trials.com. Unique identifier: ISRCTN35739639.

Authors+Show Affiliations

From the Lipid Clinic, Endocrinology and Nutrition Service, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Hospital Clínic, Barcelona, Spain (A.S.-V., E.R.); Ciber Fisiopatología de la Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain (A.S.-V., E.-S.R.-M., I.N., R.d.l.T., D.C., V.R.-G., M.-C.L.-S., X.P., J.R., M.-Á.M.-G., R.E., E.R.); Department of Internal Medicine, IDIBAPS, Hospital Clinic, Barcelona, Spain (E.-S.R.-M., R.E.); Diagnostic Imaging Centre, IDIBAPS, Hospital Clínic, Barcelona, Spain (R.G., I.N.); Human Pharmacology and Clinical Neurosciences Research Group, Institut de Investigacions Mèdiques Hospital del Mar, Barcelona, Spain (R.d.l.T.); Department of Preventive Medicine, University of Valencia, Valencia, Spain (D.C.); Instituto de la Grasa, Consejo Superior de Investigaciones Cientificas, Sevilla, Spain (V.R.-G.); Department of Nutrition and Food Science, School of Pharmacy, XaRTA, INSA, University of Barcelona, Barcelona, Spain (M.-C.L.-S.); Lipids and Vascular Risk Unit, Internal Medicine, Hospital Universitario de Bellvitge, Hospitalet de Llobregat, Barcelona, Spain (X.P.); Department of Cardiology, University Hospital of Alava, Vitoria, Spain (J.R.); and Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra-Clínica Universidad de Navarra, Pamplona, Spain (M.-Á.M.-G.).No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24285581

Citation

Sala-Vila, Aleix, et al. "Changes in Ultrasound-assessed Carotid Intima-media Thickness and Plaque With a Mediterranean Diet: a Substudy of the PREDIMED Trial." Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 34, no. 2, 2014, pp. 439-45.
Sala-Vila A, Romero-Mamani ES, Gilabert R, et al. Changes in ultrasound-assessed carotid intima-media thickness and plaque with a Mediterranean diet: a substudy of the PREDIMED trial. Arterioscler Thromb Vasc Biol. 2014;34(2):439-45.
Sala-Vila, A., Romero-Mamani, E. S., Gilabert, R., Núñez, I., de la Torre, R., Corella, D., ... Ros, E. (2014). Changes in ultrasound-assessed carotid intima-media thickness and plaque with a Mediterranean diet: a substudy of the PREDIMED trial. Arteriosclerosis, Thrombosis, and Vascular Biology, 34(2), pp. 439-45. doi:10.1161/ATVBAHA.113.302327.
Sala-Vila A, et al. Changes in Ultrasound-assessed Carotid Intima-media Thickness and Plaque With a Mediterranean Diet: a Substudy of the PREDIMED Trial. Arterioscler Thromb Vasc Biol. 2014;34(2):439-45. PubMed PMID: 24285581.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Changes in ultrasound-assessed carotid intima-media thickness and plaque with a Mediterranean diet: a substudy of the PREDIMED trial. AU - Sala-Vila,Aleix, AU - Romero-Mamani,Edwin-Saúl, AU - Gilabert,Rosa, AU - Núñez,Isabel, AU - de la Torre,Rafael, AU - Corella,Dolores, AU - Ruiz-Gutiérrez,Valentina, AU - López-Sabater,María-Carmen, AU - Pintó,Xavier, AU - Rekondo,Javier, AU - Martínez-González,Miguel-Ángel, AU - Estruch,Ramon, AU - Ros,Emilio, Y1 - 2013/11/27/ PY - 2013/11/29/entrez PY - 2013/11/29/pubmed PY - 2014/3/22/medline KW - carotid intima-media thickness KW - carotid stenosis KW - diet, Mediterranean KW - nuts KW - olive oil SP - 439 EP - 45 JF - Arteriosclerosis, thrombosis, and vascular biology JO - Arterioscler. Thromb. Vasc. Biol. VL - 34 IS - 2 N2 - OBJECTIVE: The Prevención con Dieta Mediterránea (PREDIMED) trial showed that a Mediterranean diet (MedDiet) supplemented with either extra virgin olive oil or 30 g/d of mixed nuts reduced incident cardiovascular events compared with a control (low fat) diet. The mechanisms of cardiovascular protection afforded by MedDiets remain to be uncovered. We assessed the effect of both supplemented MedDiets on internal carotid intima-media thickness (ICA-IMT) and plaque height, the ultrasound features that best predict future cardiovascular events, in subjects at high cardiovascular risk. APPROACH AND RESULTS: In a PREDIMED subcohort (n=175), plaque height and carotid IMT of 3 prespecified segments (ICA, bifurcation, and common) were sonographically assessed at baseline and after intervention for a mean of 2.4 years. We evaluated 164 subjects with complete data. In a multivariate model, mean ICA-IMT progressed in the control diet group (mean [95% confidence interval], 0.052 mm [-0.014 to 0.118 mm]), whereas it regressed in the MedDiet+nuts group (-0.084 mm [-0.158 to -0.010 mm]; P=0.024 versus control). Similar results were observed for maximum ICA-IMT (control, 0.188 mm [0.077 to 0.299 mm]; MedDiet+nuts, -0.030 mm [-0.153 to 0.093 mm]; P=0.034) and maximum plaque height (control, 0.106 mm [0.001 to 0.210 mm]; MedDiet+nuts, -0.091 mm [-0.206 to 0.023 mm]; P=0.047). There were no changes in ICA-IMT or plaque after the MedDiet+extra virgin olive oil. CONCLUSIONS: Compared with a control diet, consumption of a MedDiet supplemented with nuts is associated with delayed progression of ICA-IMT and plaque. The results contribute mechanistic evidence for the reduction of cardiovascular events observed in the PREDIMED trial. CLINICAL TRIAL REGISTRATION URL: http://www.controlled-trials.com. Unique identifier: ISRCTN35739639. SN - 1524-4636 UR - https://www.unboundmedicine.com/medline/citation/24285581/Changes_in_ultrasound_assessed_carotid_intima_media_thickness_and_plaque_with_a_Mediterranean_diet:_a_substudy_of_the_PREDIMED_trial_ L2 - http://www.ahajournals.org/doi/full/10.1161/ATVBAHA.113.302327?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -