1.
Remnant Cholesterol, Not LDL Cholesterol, Is Associated With Incident Cardiovascular Disease.
Castañer, O, Pintó, X, Subirana, I, Amor, AJ, Ros, E, Hernáez, Á, Martínez-González, MÁ, Corella, D, Salas-Salvadó, J, Estruch, R, et al
Journal of the American College of Cardiology. 2020;(23):2712-2724
Abstract
BACKGROUND Genetic, observational, and clinical intervention studies indicate that circulating levels of triglycerides and cholesterol transported in triglyceride-rich lipoproteins (remnant cholesterol) can predict cardiovascular events. OBJECTIVES This study evaluated the association of triglycerides and remnant cholesterol (remnant-C) with major cardiovascular events in a cohort of older individuals at high cardiovascular risk. METHODS This study determined the baseline lipid profile and searched for major adverse cardiovascular events (MACEs) in the high-risk primary prevention PREDIMED (Prevención con Dieta Mediterránea) trial population (mean age: 67 years; body mass index: 30 kg/m2; 43% men; 48% with diabetes) after a median follow-up of 4.8 years. Unadjusted and adjusted Cox proportional hazard models were used to assess the association between lipid concentrations (either as continuous or categorical variables) and incident MACEs (N = 6,901; n cases = 263). RESULTS In multivariable-adjusted analyses, triglycerides (hazard ratio [HR]: 1.04; 95% confidence interval [CI]: 1.02 to 1.06, per 10 mg/dl [0.11 mmol/l]; p < 0.001), non-high-density lipoprotein cholesterol (HDL-C) (HR: 1.05; 95% CI: 1.01 to 1.10, per 10 mg/dl [0.26 mmol/l]; p = 0.026), and remnant-C (HR: 1.21; 95% CI: 1.10 to 1.33, per 10 mg/dl [0.26 mmol/l]; p < 0.001), but not low-density lipoprotein cholesterol (LDL-C) or HDL-C, were associated with MACEs. Atherogenic dyslipidemia (triglycerides >150 mg/dl [1.69 mmol/l] and HDL-C <40 mg/dl [1.03 mmol/l] in men or <50 mg/dl [1.29 mmol/l] in women) was also associated with MACEs (HR: 1.44; 95% CI: 1.04 to 2.00; p = 0.030). Remnant-C ≥30 mg/dl (0.78 mmol/l) differentiated subjects at a higher risk of MACEs compared with those at lower concentrations, regardless of whether LDL-C levels were on target at ≤100 mg/dl (2.59 mmol/l). CONCLUSIONS In overweight or obese subjects at high cardiovascular risk, levels of triglycerides and remnant-C, but not LDL-C, were associated with cardiovascular outcomes independent of other risk factors.
2.
Hypertensive status and lipoprotein oxidation in an elderly population at high cardiovascular risk.
Guxens, M, Fitó, M, Martínez-González, MA, Salas-Salvadó, J, Estruch, R, Vinyoles, E, Fiol, M, Corella, D, Arós, F, Gómez-Gracia, E, et al
American journal of hypertension. 2009;(1):68-73
Abstract
BACKGROUND In elderly individuals, hypertension is a main risk factor for cardiovascular disease and oxidative damage is increased. Our aim was to assess the relationship between the degree of in vivo low-density lipoprotein (oxLDL) oxidation and the hypertensive status in a elderly population at high cardiovascular risk. METHODS Cross-sectional study with baseline data from the PREDIMED (PREvención con DIeta MEDiterránea) trial, an intervention study directed at testing the efficacy of the Mediterranean diet on the primary prevention of cardiovascular disease. Participants were 1,130 subjects at high cardiovascular risk aged 55-80. At baseline, in vivo circulating oxLDL was measured, and stages of hypertension determined according to the USA Joint National Committee guidelines. RESULTS A positive relationship between in vivo oxLDL and systolic and diastolic blood pressure (DBP) was observed after adjusting for confounding factors (P < 0.05). OxLDL concentrations increased in a linear manner from low to high hypertensive stages (P < 0.05). CONCLUSIONS Elderly individuals at high cardiovascular risk showed higher levels of circulating oxLDL when their hypertensive status increased. This fact identifies the hypertensive elderly population as a target for antioxidant preventive measures.
3.
Effects of soluble fiber (Plantago ovata husk) on plasma lipids, lipoproteins, and apolipoproteins in men with ischemic heart disease.
Solà, R, Godàs, G, Ribalta, J, Vallvé, JC, Girona, J, Anguera, A, Ostos, M, Recalde, D, Salazar, J, Caslake, M, et al
The American journal of clinical nutrition. 2007;(4):1157-63
-
-
Free full text
-
Abstract
BACKGROUND New dietary strategies to reduce cardiovascular disease (CVD) risk include the addition of fiber to the diet. The effect of soluble-fiber consumption derived from Plantago ovata husk on lipid risk factors in patients with CVD is unknown. OBJECTIVE We compared the effects of soluble fiber (P. ovata husk) with those of insoluble fiber (P. ovata seeds) on plasma lipid, lipoprotein, and apolipoprotein (apo) concentrations within a CVD secondary prevention program. DESIGN In a randomized, crossover, controlled, single-blind design, 28 men with CVD (myocardial infarction or stable angina) and an LDL-cholesterol concentration ≤3.35 mmol/L consumed for 8 wk, under controlled conditions, a low-saturated-fat diet supplemented with 10.5 g P. ovata husk/d or 10.5 g P. ovata seeds/d. Fasting plasma lipid concentrations and polymorphisms of genes involved in lipid metabolism, such as apo A-IV, apo E, and fatty acid-binding protein, were measured. RESULTS Plasma triacylglycerol decreased (6.7%; P < 0.02), the ratio of apo B 100 to apo A-I decreased (4.7%; P < 0.02), and apo A-I increased (4.3%; P < 0.01) in the P. ovata husk consumers. Compared with the intake of insoluble fiber, the intake of P. ovata husk increased HDL-cholesterol concentrations by 6.7% (P = 0.006) and decreased the ratio of total to HDL cholesterol and of LDL to HDL cholesterol by 10.6% (P = 0.002) and 14.2% (P = 0.003), respectively. CONCLUSION In the secondary prevention of CVD, P. ovata husk intake induces a more beneficial effect on the cardiovascular lipid risk-factor profile than does an equivalent intake of insoluble fiber.