Cohort studies coronary heart disease

In addition, five prospective within-population cohort studies have been carried out, four of them on coronary heart disease and one on strokes. The four coronary heart disease studies were carried out in The Netherlands (Zutphen) [139], the USA (Health Professionals study) [140], the U.K. (the Caerphilly study) [141], and Finland [142]. In the Zutphen study, coronary heart disease was inversely associated with flavonol intake, in which a maximum intake of 42 mg/day and a minimum of 12mg/day were recorded. A clear dose-response correlation was observed. In the Health Professionals study, a modest non-significant inverse association was found (flavonoid intake between 40 mg/day and 7 mg/day). The Finnish study indicated a weak inversely associated correlation, while the Caerphilly study involving Welsh men showed that flavonoid intake increased the mortality. 

Dauchet, L. et al., Fruit and vegetable consumption and risk of coronary heart disease a meta-analysis of cohort studies, J. Nutr., 136, 2588, 2006. 

He, K., Song, Y., Daviglus, M. L., Liu, K., Van Horn, L., Dyer, A. R., and Greenland, P. (2004). Accumulated evidence on fish consumption and coronary heart disease mortality. A meta-analysis of cohort studies. Circulation 109,2705-2711. 

Almgren T, Persson B, Wilhelmsen L, Rosengren A, An-dersson OK. Stroke and coronary heart disease in treated hypertension - a prospective cohort study over three decades. I Intern Med 2005 257(6) 496-502. 

The same authors [204] confirmed these results in the Seven Country Study. The contribution of flavonols and flavones in explaining the variance in coronary heart disease mortality rates across 16 cohorts from seven countries was studied. Flavonol and flavone intake was inversely correlated with mortality from coronary heart disease. These finding are in line with the results of a cohort study in Finnland [205], where a significant inverse gradient was observed between dietary intake of flavonoids and total and coronary mortality. 

A modest but not significant inverse correlation between the intake of flavonols and flavones and subsequent mortality rates was found in a prospective cohort study of US Health Professionals by Rimm et al [206]. The authors do not exclude that flavonoids have a protective effect in men with established coronary heart disease although strong evidence was missing. Also other studies failed to demonstrate a significant statistical association between the intake of polyphenols and CHD. In Great Britain for instance coronary and total mortality even rose with the intake of the major flavonol source, tea [207], The most likely explanation for the latter observation is that in this study tea consumption merely acted as a marker for a lifestyle that favours the development of cardiovascular disease. Indeed, men with the highest intake of tea and flavonols tended to be manual workers, and they smoked more and ate more fat [208],... 

Huxley RR, Neil HAW. 2003. The relation between dietary flavonol intake and coronary heart disease mortality A meta-analysis of prospective cohort studies. 

I 90 Pietinen P Rimm EB, Korkonen R et al, Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Cancer Prevention Study. Circulation 1996 94 2720-2727,... 

Coronary heart disease is associated with ischemic stroke in postmortem (Stemmermann et al. 1984), twin (Brass et al. 1996), case-control (Feigin et al. 1998) and cohort studies (Harmsen et al. 1990 Shaper et al. 1991 Wolf et al. 1991b Touze et al. 2006) as are electrocardiographic abnormalities, cardiac failure, left ventricular hypertrophy, claudication and asymptomatic peripheral vascular disease (Leys et al. 2006). 

The emerging evidence from the past two decades suggests the potential role of flavonoids in the prevention of coronary heart disease. Hertog et al. (1993, 1995) demonstrated that flavonoid intake was inversely related to the incidence of coronary heart disease. Another cohort study by Knekt et al. (1996) supported the conclusion that flavonoids may have a preventive role against coronary heart disease. 

Erkkila AT, Lehto S, Pyorala K, Uusitupa MI. n-3 fatty acids and 5-y risks of death and cardiovascular disease events in patients with coronary artery disease. Am. J. CUn. Nutr. 2003 78 65-71. He K, Song Y, Daviglus ML, Liu K, Van Horn L, Dyer AR, Greenland P. Accumulated evidence on fish consumption and coronary heart disease mortaUty a meta-analysis of cohort studies. Circulation 2004 109 2705-2711. 

Ray WA, Stein CM, Hall K, Daugherty JR, Griffin MR. Non-steroidal anti-inflammatory drugs and risk of serious coronary heart disease an observational cohort study. Lancet 2002 359(9301) 118-23. 

Several cohort studies have been performed in which the relationships between flavonoid intake and the risk of coronary heart disease have been investigated. The studies have shown that the mortality from coronary heart diseases (CHD) is inversely correlated with the intake of flavonoids in the diet. Hollman and Katan (1998) summarize that in three out of five cohort studies, in addition to one cross-cultural study, flavonoids from the flavonol and flavone subgroups demonstrated a protective role toward cardiovascular disease. The protective effect of the flavonoids is partly explained by the inhibition of LDL oxidation and by reduced platelet aggregability. As reviewed by Cook and Samman (1996), there are several possible routes as to how LDL is oxidized by free radicals generated in the cells and how the oxidized LDL initiates and promotes atherosclerosis in the human body. 

Ascherio, A. E.B. Rimm E.L. Giovannucci D. Spiegelman M. Stampfer W.C. Willett. Dietaty fat and risk of coronary heart disease in men Cohort follow up study in the United States. Br. Med. J. 1996b, 313, 84-90. 

Pietinen, P. A. Ascherio P. Kothonen A.M. Hartman W.C. Willett D. Albanes J. Virtamo. Intake of fatty acids and risk of coronary heart disease in a cohort of Finnish men The alpha-tocopherol, beta-carotene cancer prevention study. Am. J. Epidemiol 1997, 145, 876—887. 

Hu FB, Stampfer MJ, Manson JE, et al. Frequent nut consumption and risk of coronary heart disease prospective cohort study. BMJ 1998 317 1341-1345. 

The Nurses Health Study (Puett et al. 2008) examined the association of chronic particulate exposures with all-cause mortality, incident nonfatal myocardial infarction, and fatal coronary heart disease (CHD) in a prospective cohort of 66,250 women from the Nurses Health Study in north-eastern US metropolitan areas. In an age- and season-of-the-year-adjusted models, 10 pg/m increases in 12-month average exposures to PMio were associated with increased all-cause mortality (RR 1.16, 95% Cl 1.05-1.28) and fatal CHD (1.43, 95% Cl 1.10-1.86). 

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