Home Search Sitemap Contact Bookmark

Free Dissertations - Health Dissertations

(singh R B Et Al. 1992). These Trials Were Followed By A Number Of Others ...

(Singh R B et al. 1992). These trials were followed by a number of others which largely corroborated these findings by demonstrating the cardioprotective effects of each of these subtypes individually. (viz. Gilman M W et al. 1995 and Albert C M et al. 1998). Much of the work showed a particularly strong cardioprotective effect to be associated with the omega 3 fatty acid and folate intake (Daviglus M L et al. 1997). These particular entities were studied because of their putative action in both hyperhomocysteinemia and the argininenitric oxidetetrahydrobiopterin pathway both of which are considered to be major mediators in the overall development of coronary artery disease (Verhaar M C et al. 1998). Many of these trials reported beneficial results but, as a generalisation, they tended to have a small entry cohort and therefore a small number of significant coronary events and therefore did not contribute significantly towards the general evidence base on the subject.


A significant landmark in this evolution came with the Lyon Diet Heart Study (de Lorgeril M et al. 1999) which was a large scale randomised single blind secondary prevention trial and it compared the long term effects of a Mediterranean Diet and a typical Western Diet on the morbidity trajectory after an initial entry episode of myocardial infarction. It covered 275 new events with an average follow up time of nearly 4 years per patient.

The trial is both long and complex with a significant statistical component but, in essence, it found that the cardioprotective effects of the Mediterranean Diet were not only proven, but were maintained for the 4 years of follow up after the first episode of myocardial infarction. Significantly, other factors such as the already known indicators of raised cholesterol levels and raised blood pressure were shown to be independent of the benefits conferred by the Mediterranean Diet. The Lyon Study was the first to show a secure evidence base for the hypothesis that cardiovascular morbidity (and mortality) should not only be treated by the traditional methods of reducing blood pressure and other risk factors but also by modifying the diet as part of a holistic approach to the problem.

In terms of absolute effect, the authors point to the fact that the results of the trial suggest that the cardiac event rate (both fatal and non-fatal groups) was 1.24 per 100 patients per year in the Mediterranean Diet group as compared to 5.55 in the ordinary diet group, which is impressive by any comparison.

In order to put these results into perspective we should compare and contrast them with the other widely recognised and accepted risk factors of cardiovascular disease.


Thanks