Re: Should a women get a statin

On Oct 31, 1:03 pm, "Juhana Harju" <n...@xxxxxxx> wrote:
MarilynMann wrote:
What do you propose for women who are at high cardiovascular risk?

A traditional Cretan type of Mediterranean diet, fish oil supplementation, a
daily glass of red wine and increased exercise would be a good start.
Inclusion of nuts to the daily diet is important as that has been associated
with hugely reduced cardiovascular risk in women.

A fresh study:

Combined Effect of Low-Risk Dietary and Lifestyle Behaviors in Primary
Prevention of Myocardial Infarction in Women
Agneta Åkesson, PhD, MPH; Christoph Weismayer, PhD; P. K. Newby, ScD, MPH,
MS; Alicja Wolk, DMSc
Arch Intern Med. 2007;167:2122-2127.

_Background_ Limited data are available on the benefit of combining healthy
dietary and lifestyle behaviors in the prevention of myocardial infarction
(MI) in women.

_Methods_ We used factor analysis to identify a low-risk behavior-based
dietary pattern in 24 444 postmenopausal women from the population-based
prospective Swedish Mammography Cohort who were free of diagnosed cancer,
cardiovascular disease, and diabetes mellitus at baseline (September 15,
1997). We also defined 3 low-risk lifestyle factors: nonsmoking, waist-hip
ratio less than the 75th percentile (< 0.85), and being physically active
(at least 40 minutes of daily walking or bicycling and 1 hour of weekly
exercise).

_Results_ During 6.2 years (151 434 person-years) of follow-up, we
ascertained 308 cases of primary MI. Two major identified dietary patterns,
"healthy" and "alcohol," were significantly associated with decreased risk
of MI. The low-risk diet (high scores for the healthy dietary pattern)
characterized by a high intake of vegetables, fruit, whole grains, fish, and
legumes, in combination with moderate alcohol consumption ( 5 g of alcohol
per day), along with the 3 low-risk lifestyle behaviors, was associated with
92% decreased risk (95% confidence interval, 72%-98%) compared with findings
in women without any low-risk diet and lifestyle factors. This combination
of healthy behaviors, present in 5%, may prevent 77% of MIs in the study
population.

_Conclusion_ Most MIs in women may be preventable by consuming a healthy
diet and moderate amounts of alcohol, being physically active, not smoking,
and maintaining a healthy weight.

http://archinte.ama-assn.org/cgi/content/abstract/167/19/2122

Couple of nut studies:

Frequent nut consumption and risk of coronary heart disease in women:
prospective cohort study
Editorial by Tunstall-Pedoe
Frank B Hu, research associate, Meir J Stampfer, professor, JoAnn E Manson,
associate professor, Eric B Rimm, associate professor, Graham A Colditz,
professor, Bernard A Rosner, professor, Frank E Speizer, professor, Charles
H Hennekens, professor, Walter C Willett, professor
BMJ 1998;317:1341-1345

Objective: To examine the relation between nut consumption and risk of
coronary heart disease in a cohort of women from the Nurses' Health Study.
Design: Prospective cohort study.
Setting: Nurses' Health Study.
Subjects: 86 016 women from 34 to 59 years of age without previously
diagnosed coronary heart disease, stroke, or cancer at baseline in 1980.
Main outcome measures: Major coronary heart disease including non-fatal
myocardial infarction and fatal coronary heart disease.
Results: 1255 major coronary disease events (861 cases of non-fatal
myocardial infarction and 394 cases of fatal coronary heart disease)
occurred during 14 years of follow up. After adjusting for age, smoking, and
other known risk factors for coronary heart disease, women who ate more than
five units of nuts (one unit equivalent to 1 oz of nuts) a week (frequent
consumption) had a significantly lower risk of total coronary heart disease
(relative risk 0.65, 95% confidence interval 0.47 to 0.89, P for
trend=0.0009) than women who never ate nuts or who ate less than one unit a
month (rare consumption). The magnitude of risk reduction was similar for
both fatal coronary heart disease (0.61, 0.35 to 1.05, P for trend=0.007)
and non-fatal myocardial infarction (0.68, 0.47 to 1.00, P for trend=0.04).
Further adjustment for intakes of dietary fats, fibre, vegetables, and
fruits did not alter these results. The inverse association persisted in
subgroups stratified by levels of smoking, use of alcohol, use of
multivitamin and vitamin E supplements, body mass index, exercise, and
intake of vegetables or fruits.
Conclusions: Frequent nut consumption was associated with a reduced risk of
both fatal coronary heart disease and non-fatal myocardial infarction. These
data, and those from other epidemiological and clinical studies, support a
role for nuts in reducing the risk of coronary heart disease.

http://www.bmj.com/cgi/content/full/317/7169/1341

A possible protective effect of nut consumption on risk of coronary heart
disease. The Adventist Health Study
G. E. Fraser, J. Sabate, W. L. Beeson and T. M. Strahan
Center for Health Research, School of Public Health, Loma Linda University,
CA 92350.
Arch Intern Med. 1992 Jul;152(7):1416-24.

BACKGROUND--Although dietary factors are suspected to be important
determinants of coronary heart disease (CHD) risk, the direct evidence is
relatively sparse. METHODS--The Adventist Health Study is a prospective
cohort investigation of 31,208 non-Hispanic white California Seventh-Day
Adventists. Extensive dietary information was obtained at baseline, along
with the values of traditional coronary risk factors. These were related to
risk of definite fatal CHD or definite nonfatal myocardial infarction.
RESULTS--Subjects who consumed nuts frequently (more than four times per
week) experienced substantially fewer definite fatal CHD events (relative
risk, 0.52; 95% confidence interval [CI], 0.36 to 0.76) and definite
nonfatal myocardial infarctions (relative risk, 0.49; 95% CI, 0.28 to 0.85),
when compared with those who consumed nuts less than once per week. These
findings persisted on covariate adjustment and were seen in almost all of 16
different subgroups of the population. Subjects who usually consumed whole
wheat bread also experienced lower rates of definite nonfatal myocardial
infarction (relative risk, 0.56; 95% CI, 0.35 to 0.89) and definite fatal
CHD (relative risk, 0.89; 95% CI, 0.60 to 1.33) when compared with those who
usually ate white bread. Men who ate beef at least three times each week had
a higher risk of definite fatal CHD (relative risk, 2.31; 95% CI, 1.11 to
4.78), but this effect was not seen in women or for the nonfatal myocardial
infarction end point. CONCLUSION--Our data strongly suggest that the
frequent consumption of nuts may protect against risk of CHD events. The
favorable fatty acid profile of many nuts is one possible explanation for
such an effect.

http://archinte.ama-assn.org/cgi/content/abstract/152/7/1416

--
Juhana

http://ruohikolla.blogspot.com/

This is great, and I obviously don't disagree with making lifestyle
changes, but there are some women that are unwilling to do that or for
whom such changes are insufficient.

Marilyn

.

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