Coronary heart disease preventative, evening

Heterozygous carriers of functionally relevant mutations usually present with HDL cholesterol levels that are frequently below the fifth percentile. As would be expected, apoA-I levels are also frequently below the fifth percentile (i.e., < 1.05 g/1 and < 1.1 g/1 in Caucasian men and women, respectively). In most cases, heterozygous carriers of apoA-I variants do not present with specific clinical symptoms. An important exception are some structural apoA-I variants with amino acid substitutions in the amino terminus, which have been detected in patients with familial amyloidosis of the liver, the intestine, the kidney, the heart, peripheral nerves, and in the skin. In addition, some apoA-I variants like apoA-I L178P or L159P have been associated with increased risk of premature coronary heart disease or enhanced progression of carotid intima media thickness, whereas others did not show this association, or were even claimed to have reduced cardiovascular risk and advocated as possible agents for the treatment or prevention of atherosclerosis (notably apoA-I R173CMiiano) [22,43,53]. 

Cardiovascular diseases are a major cause of death in developed countries, making prevention a priority for public health policy. Research evidence over years has shown that cardiovascular diseases can be managed and even prevented by healthful eating practices involving a resveratrol-enriched diet of whole plant foods such as offered by superfruits. For more than fifty years, research has shown that a healthful, active lifestyle combined with the dietary benefit of high fruit and vegetable intake may lower blood lipid levels, blood pressure, and risk of coronary heart disease and stroke. 

It should not be considered too late for intervention, even if a patient has advanced coronary heart disease or has suffered a mytKardial infarction. The benefits of secondary prevention are well established, particularly with statin therapy which has been shown to reduce all-cause mortality even in patients with apparently normal total cholesterol levels. 

The literature provides information that correlates a diet rich in phenolic acids with the maintenance of health and disease prevention. The high antioxidant contents in fruits and vegetables inhibit oxidative damage diseases such as coronary heart disease, stroke, and cancers [40-42]. Certain foods are even classified as functional foods, owing to their established protective effects on human health. 

Since on the other hand overweight is indirectly one of the risk factors of atherosclerosis, especially of heart infarction, it is of advantage to recommend a moderate intake of carbohydrates for the dietary prevention of coronary heart disease. This should be taken into consideration even if it would lack the final proof e.g. by epidemiological investigations for the importance of certain sugars in the pathogenesis of atherosclerotic disease. 

---