Impact of diet on 10-year absolute cardiovascular risk: A prospective population-based cohort study

Abstract

Background and Aims : The burden of diet on cardiovascular risk is substantial. Current dietary guidelines are not sufficiently implemented and effective strategies to encourage people to change and maintain healthy diets are lacking. The impact of incorporating dietary assessment into 10-year absolute risk charts for cardiovascular disease is unknown.Methods: Using a prospective cohort design including 94,321 individuals from the general population, we generated 10-year absolute risk scores for fatal and non-fatal cardiovascular disease and for ischemic vascular disease according to groups based on adherence to dietary guidelines.Results: Non-adherence to dietary guidelines was associated with an atherogenic lipid and inflammatory profile. In both sexes, 10-year absolute risk of ischemic vascular disease increased with increasing age, increasing systolic blood pressure, and decreasing adherence to dietary guidelines. The highest 10-year absolute risk of ischemic vascular disease of 38% was observed in smoking men aged 65-69 with very low adherence to dietary guidelines and systolic blood pressure between 160-179. The corresponding value for women was 26%. Risk charts using non-HDL cholesterol instead of dietary assessment yielded similar estimates.Conclusions: Incorporation of dietary assessment into 10-year absolute risk charts may contribute to a more effective prevention strategy as it may improve individual motivation to change dietary habits and therefore advance personalized prevention. These risk charts may also be useful in regions of the world where access to laboratory facilities is limited. Improved implementation of national dietary guidelines must be a cornerstone for future prevention of cardiovascular disease in both younger and older individuals. Background and Aims : The burden of diet on cardiovascular risk is substantial. Current dietary guidelines are not sufficiently implemented and effective strategies to encourage people to change and maintain healthy diets are lacking. The impact of incorporating dietary assessment into 10-year absolute risk charts for cardiovascular disease is unknown. Methods: Using a prospective cohort design including 94,321 individuals from the general population, we generated 10-year absolute risk scores for fatal and non-fatal cardiovascular disease and for ischemic vascular disease according to groups based on adherence to dietary guidelines. Results: Non-adherence to dietary guidelines was associated with an atherogenic lipid and inflammatory profile. In both sexes, 10-year absolute risk of ischemic vascular disease increased with increasing age, increasing systolic blood pressure, and decreasing adherence to dietary guidelines. The highest 10-year absolute risk of ischemic vascular disease of 38% was observed in smoking men aged 65-69 with very low adherence to dietary guidelines and systolic blood pressure between 160-179. The corresponding value for women was 26%. Risk charts using non-HDL cholesterol instead of dietary assessment yielded similar estimates. Conclusions: Incorporation of dietary assessment into 10-year absolute risk charts may contribute to a more effective prevention strategy as it may improve individual motivation to change dietary habits and therefore advance personalized prevention. These risk charts may also be useful in regions of the world where access to laboratory facilities is limited. Improved implementation of national dietary guidelines must be a cornerstone for future prevention of cardiovascular disease in both younger and older individuals.