The correlation between good dietary habits and the prevention of heart disease is well established. What isn't known is whether that benefit extends to people already being treated for heart disease. The authors of a recent prospective study evaluated data from two large international trials involving a total of 31,546 patients who were at least 55 years old and had a history of coronary, peripheral, or cerebrovascular disease or diabetes mellitus with end-organ damage. All patients were receiving ramipril, telmisartan, a combination of the two, or placebo, as determined in the individual randomized trials. A modified version of the Alternative Health Eating Index (mAHEI) was used to measure healthful eating, with higher scores indicating more frequent consumption of healthful foods. The primary outcome of both studies was defined as a composite of cardiovascular disease-related death, myocardial infarction (MI), nonfatal stroke, or congestive heart failure requiring hospitalization.

In comparing patients with the highest mAHEI scores with those with the lowest scores, and after adjusting for a number of variables, the authors noted a significantly lower risk of primary outcome events in those with the higher mAHEI scores. The benefits of a high-quality diet were noted regardless of whether patients were taking aspirin, ?-blockers, or statins and were consistent across regions and income levels. Greater intake of vegetables, fruit, soy protein, and alcohol were all associated with a small but significant reduction in risk of primary outcome events, but a higher risk was seen with greater consumption of meat, poultry, and eggs. In terms of the individual components of the primary end point, patients with higher mAHEI scores had a 35% lower risk of cardiovascular disease-related death, 14% lower risk of MI, and 19% lower risk of stroke.

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