Cardiovascular disease Prevention Study

Low levels of vitamin E have been associated with increased incidence of coronary artery disease. Observational studies have therefore suggested that supplemental a-tocopherol might have value in the treatment of cardiovascular disease. Clinical studies demonstrated contradicting results regarding the benefits of vitamin E in the prevention of cardiovascular disease. Four... 

Recently, another plausible mechanistic basis for isoflavone-mediated cardiovascular disease prevention has been proposed. In a study to find the... 

Bioavailability studies are essential if we are to understand the possible role of plant phenolics in cardiovascular disease prevention. Recent studies showing that food flavonoids can be absorbed as glycosides, which goes against conventional knowledge concerning flavonoid absorption, indicate the need for such bioavailability studies. 

Hyperlipidemia and obesity are risk factors of lifestyle-related diseases such as diabetes, hypertension, arteriosclerosis, and cardiovascular diseases. Numerous studies have been conducted to examine food ingredients that can prevent obesity. Diacylglycerol (DAG) is one of the ideal fats that may prevent postprandial hyperlipidemia and obesity [see references contain in this volume (1)]. 

Brown TM, Parmar G, Durant RW, Halanych JH, Hovater M, Muntner P, Prineas RJ, Roth DL, Samdarshi TE, Safford MM. (2011). Health professional shortage areas, insurance status, and cardiovascular disease prevention in the reasons for geographic and racial differences in stroke (REGARDS) study. Journal of Health Care for the Poor and Underserved, 22(4) 1179-1189. 

The a-tocopherol, P-carotene (ATBC) Cancer Prevention study was a randomised-controlled trial that tested the effects of daily doses of either 50 mg (50 lU) vitamin E (all-racemic a-tocopherol acetate), or 20 mg of P-carotene, or both with that of a placebo, in a population of more than 29,000 male smokers for 5-8 years. No reduction in lung cancer or major coronary events was observed with any of the treatments. What was more startling was the unexpected increases in risk of death from lung cancer and ischemic heart disease with P-carotene supplementation (ATBC Cancer Prevention Study Group, 1994). Increases in the risk of both lung cancer and cardiovascular disease mortality were also observed in the P-carotene and Retinol Efficacy Trial (CARET), which tested the effects of combined treatment with 30 mg/d P-carotene and retinyl pahnitate (25,000 lU/d) in 18,000 men and women with a history of cigarette smoking or occupational exposure to asbestos (Hennekens et al, 1996). 

In the Unites States, the daily intake of 3-carotene is around 2 mg/day Several epidemiological studies have reported that consumption of carotenoid-rich foods is associated with reduced risks of certain chronic diseases such as cancers, cardiovascular disease, and age-related macular degeneration. These preventive effects of carotenoids may be related to their major function as vitamin A precursors and/or their actions as antioxidants, modulators of the immune response, and inducers of gap-junction communications. Not all carotenoids exert similar protective effects against specific diseases. By reason of the potential use of carotenoids as natural food colorants and/or for their health-promoting effects, research has focused on better understanding how they are absorbed by and metabolized in the human body. 

In addition to effects on bone, raloxifene may have effects in breast tissue and on the cardiovascular system. A secondary end point of the MORE trial evaluated the effects of raloxifene on the primary prevention of breast cancer and found a significant reduction in all types of breast cancer.33 Raloxifene decreases total and low-density lipoprotein (LDL) cholesterol,34 and studies are evaluating its effect on reducing the risk of cardiovascular disease.35... 

DF is a major constituent of plant foods, and its importance in nutrition and health is widely recognized. Numerous clinical and epidemiological studies have addressed the role of DF in intestinal health and in the prevention of cardiovascular disease and cancer, obesity, and diabetes (Sungsoo Cho and Dreher 2001 Spiller 2005). The recommended daily intake of DF is 25-30 g/person (Lunn and Buttriss 2007). 

Hormone therapy has proven highly effective in controlling the menopausal syndrome, especially severe hot flushes (MacLennan et al. 2004), even at doses significantly lower than those used until now (Speroff et al. 2000 Utian et al. 2001). Women s Health Initiative studies found that hormone replacement therapy, when administered as a primary prevention intervention for CVD in older women, increases the risk of heart disease and breast cancer. Even if a protective effect on fracture and colon cancer was observed, the risk-benefit ratio led to a recommendation of this treatment only for the short-term relief of menopausal symptoms (Rossouw et al. 2002 Anderson et al. 2004). The role of early administration of ovarian hormones to young postmenopausal women in the prevention of cardiovascular disease or late dementia remains... 

Many studies have shown that ginseng has a protective effect on the development of atherosclerosis that may lead to myocardial infarction and other cardiovascular diseases. The preventive effects on cardiovascular diseases of ginseng include its potential antihypertensive and antiatherosclerotic effects. Ginsenosides are likely to be responsible for some of these effects as they have been shown to have inhibitory effects on platelet aggregation and to suppress thrombin formation as well as an effect on blood vessel contraction. 

Subsequent studies in experimental animals have yielded provocative results. Resveratrol is known to extend the lifespan of a number of organisms from yeast to vertebrates. Resveratrol is also known to prevent or slow the progression of cancer, cardiovascular diseases, diabetes, inflammation, and ischemic injuries in experimental animals. In short, the suggestion that resveratrol in red wine may be responsible for favorable outcomes in human health is supported by a number of studies in experimental animals. However, the support is suggestive but certainly not definitive. Carefully controlled clinical trials in people will be required to establish the role, if any, of resveratrol or related small molecules in human health. Such clinical trials are currently underway. 

The role of the antioxidant properties of vitamins C, E, and p-carotene in the prevention of cardiovascular disease has been the focus of several recent studies. Antioxidants reduce the oxidation of low-density lipoproteins, which may play a role in the prevention of atherosclerosis. However, an inverse relationship between the intake or plasma levels of these vitamins and the incidence of coronary heart disease has been found in only a few epidemiological studies. One study showed that antioxidants lowered the level of high-density lipoprotein 2 and interfered with the effects of lipid-altering therapies given at the same time. While many groups recommend a varied diet rich in fruits and vegetables for the prevention of coronary artery disease, empirical data do not exist to recommend antioxidant supplementation for the prevention of coronary disease. 

Estrogens with or without progestins should not be used for the prevention of cardiovascular disease. The Women s Health Initiative (WHI) study reported increased risks of myocardial infarction, stroke, invasive breast cancer, pulmonary emboli, and deep vein thrombosis in postmenopausal women (50 to 19 years of age) during 5 years of treatment with oral conjugated estrogens (0.625 mg) combined with medroxyprogesterone acetate (2.5 mg) relative to placebo.62... 

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