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Diet and Your Cardiovascular Health

Jim Windell

            The leading cause of death worldwide and in the U.S., cardiovascular disease is a group of diseases affecting your heart and blood vessels. Among the issues related to cardiovascular disease are narrowing of the blood vessels in your heart and other organs, heart valves that aren’t working right and irregular heart rhythms.

           Almost half of adults in the U.S. have some form of cardiovascular disease. And the disease affects people of all ages, sexes, ethnicities and socioeconomic levels. One in three women die from cardiovascular disease; one in four men will also die from this disease.

           It is well known that key lifestyle strategies that help to reduce cardiovascular risk factors are physical exercise, avoiding smoking and drinking, reducing stress and a healthy diet. However, there has been scarce data to guide us in terms of which heart-healthy diet is best for cardiovascular health.

           In a new study, recently published in the American Journal of Cardiology, researchers at Beth Israel Deaconess Medical Center (BIDMC), located in Boston, compared the effects of three eating patterns on patients' risk of experiencing a cardiovascular event within in the next ten years. Those three eating patterns were the Dietary Approaches to Stop Hypertension (DASH) diet, a diet rich in fruits and vegetables, and the Western diet that is typically low in fruits and vegetables while high in fat and sodium.

           According to Stephen P. Juraschek, M.D., Ph.D., a clinician-researcher in the Department of Medicine at BIDMC,  “While physicians and patients rely on the extensive data available when choosing appropriate pharmacologic therapy to prevent atherosclerotic cardiovascular disease, there's limited evidence to inform expectations for risk reductions from established lifestyle interventions,” Juraschek, a corresponding author in the study, went on to say that this study suggests that the benefits associated with these diets may vary by sex and race.

           In order to determine the effect of the different diets on an individual's risk of atherosclerotic cardiovascular disease, Juraschek and his colleagues acquired data from 459 adults aged 22 to 75 who participated in the original DASH trial between 1994 and 1996. Participants, who were roughly half women and half Black, were randomized to one of three diets for eight weeks. The control diet was high in total fat, saturated fat and cholesterol; the fruit and vegetable diet provided more produce, but did not otherwise significantly differ from the control diet. The DASH diet also provided more fruit and vegetables, but emphasized more whole grains, lean proteins, nuts and low-fat dairy while reducing fat, saturated fat, cholesterol and sugar.

          In previous research, the DASH diet not only reduced systolic blood pressure but also reduced HDL cholesterol levels, compared to the control diet.  In this study when the researchers compared the data, they found that both the DASH diet and the fruit and vegetable diet had lowered participants' 10-year risk for cardiovascular disease by about 10 percent overall. However, the effect was not consistent across demographics. The DASH diet reduced the 10-year risk score among women by nearly 13 percent, compared to just over six percent among men. Moreover, DASH reduced the 10-year risk score by nearly 14 percent among Black adults, versus just three percent among non-Black adults.

          “The findings could have major implications for clinical practitioners and policy makers alike,” commented first author Sun Young Jeong, M.D., M.P.H., an internal medicine resident at BIDMC. “Cardiovascular disease is the leading cause of death in women and hypertension is also more strongly linked with heart failure and death in women than men. We also know women are less likely to receive risk factor modification therapies, such as statins, so our finding that DASH may be more efficacious among women are relevant for lifestyle counseling in this group.”

          Juraschek, who is also an assistant professor of medicine at Harvard Medical School, noted that disparities in access to healthy foods has been a major focus of policy efforts to promote higher intake of fruits and vegetables among Black adults. “Our study suggests that the DASH dietary pattern may offer Black adults more prevention benefits than the emphasis on fruits and vegetables alone. This is particularly relevant as dietary pattern has been identified as one of the most important mediators of hypertension risk among Black adults.”

          To read the original journal article, find it with this reference:  

Jeong, S. Y., Wee, C.C., Kovell, L.C., Plante, T.B., Miller, E.R., Appel, L.J., Mukamal, K.J., & Juraschek, S.P. (2023). Effects of Diet on 10-Year Atherosclerotic Cardiovascular Disease Risk (from the DASH Trial). , 187, 10 – 17.