Dietary factors and risk of heart failure: A systematic review
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Corresponding author Luc Djoussé, MD, MPH, DSc Division of Aging, Brigham and Women’s Hospital and Harvard Medical School, 1620 Tremont St, 3rd floor, Boston MA 02120, USA. E-mail: [email protected] Current Cardiovascular Risk Reports 2007, 1:330–334 Current Medicine Group LLC ISSN 1932-9520 Copyright © 2007 by Current Medicine Group LLC
Heart failure (HF) remains the leading cause of hospitalization among older individuals and is associated with a higher health care and societal burden. With increasing life expectancy in the United States, more people will live to develop HF. Whereas noticeable advances in medical treatment of HF have been made over the past decade, primary prevention remains critical to curb the HF epidemic. Many of the key risk factors for HF, including hypertension and coronary heart disease, can be influenced by diet and lifestyle factors, thereby reducing the risk of HF. The present paper reviews current evidence on the effects of dietary factors, such as moderate alcohol consumption, whole grain consumption, fish intake and omega-3 fatty acids, vitamins, and minerals, on the development of HF. Current literature provides strong support for the hypothesis that the risk of HF in the population can be substantially reduced by certain dietary factors.
Introduction According to the latest American Heart Association statistics, approximately half a million patients in the United States will be diagnosed with heart failure (HF) per year. The prevalence of HF is estimated at 4.9 million in the United States, and costs associated with HF were estimated at 27.9 billion dollars for 2005 in the US [1]. The lifetime risk of HF is estimated at 20% (one in five) for both men and women aged 40 years [2]. HF is the leading cause of hospitalization among elderly people in the United States and is associated with a higher mortality. While advanced age, hypertension, diabetes mellitus, obesity, valvular heart disease, and myocardial infarc-
tion have been recognized as important predictors of HF [3], limited data are available on the effects of modifiable lifestyle factors on the risk of HF. With the exponential rise in obesity in the United States and the higher prevalence of hypertension, considering preventive measures that will eliminate or minimize major risk factors for HF in the population is important. Modifiable lifestyle and dietary factors could play an important role in achieving such goal. Unfortunately, most of the clinical trials of HF have focused on pharmacologic treatment of symptomatic HF or risk factors. This review summarizes the effects of dietary factors, including moderate alcohol consumption and intake of whole grain products, fish, omega-3 fatty acids, vitamins, and minerals in the development of HF. For each dietary factor, we review the underlying physiologic mechanisms that lend support to a causal relation.
Moderate Alcohol Consumption and Risk of HF While heavy alcohol consumption potentially leading to cardiomyopathy [4] and the development of HF is well known, limite
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