Affiliation:
1. Division of Preventive Medicine School of Medicine University of Alabama at Birmingham AL
2. Division of General Internal Medicine Weill Cornell Medical College New York NY
3. Department of Nutrition Harvard T.H. Chan School of Public Health Harvard University Boston MA
4. Division of Gastrointestinal Surgery School of Medicine University of Alabama at Birmingham AL
5. Division of Cardiovascular Disease School of Medicine University of Alabama at Birmingham AL
6. Department of Biostatistics School of Public Health University of Alabama at Birmingham AL
Abstract
Background
Previously, we reported on associations between dietary patterns and incident acute coronary heart disease (
CHD
) in the
REGARDS
(Reasons for Geographic and Racial Differences in Stroke) study. Here, we investigated the associations of dietary patterns and a dietary index with recurrent
CHD
events and all‐cause mortality in
REGARDS
participants with existing
CHD
.
Methods and Results
We included data from 3562 participants with existing
CHD
in
REGARDS
. We used Cox proportional hazards regression to examine the hazard of first recurrence of
CHD
events—definite or probable
MI
or acute
CHD
death—and all‐cause mortality associated with quartiles of empirically derived dietary patterns (convenience, plant‐based, sweets, Southern, and alcohol and salads) and the Mediterranean diet score. Over a median 7.1 years (interquartile range, 4.4, 8.9 years) follow‐up, there were 581 recurrent
CHD
events and 1098 deaths. In multivariable‐adjusted models, the Mediterranean diet score was inversely associated with the hazard of recurrent
CHD
events (hazard ratio for highest score versus lowest score, 0.78; 95% confidence interval, 0.62–0.98;
P
T
rend
=0.036). The Southern dietary pattern was adversely associated with the hazard of all‐cause mortality (hazard ratio for Q4 versus Q1, 1.57; 95% confidence interval, 1.28–1.91;
P
Trend
<0.001). The Mediterranean diet score was inversely associated with the hazard of all‐cause mortality (hazard ratio for highest score versus lowest score, 0.80; 95% confidence interval, 0.67–0.95;
P
T
rend
=0.014).
Conclusions
The Southern dietary pattern was associated with a greater hazard of all‐cause mortality in
REGARDS
participants. Greater adherence to the Mediterranean diet was associated with both a lower hazard of recurrent
CHD
events and all‐cause mortality.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
30 articles.
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