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Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions: the SHEEP case-control study.

https://arctichealth.org/en/permalink/ahliterature9623
Source
Addiction. 2003 Oct;98(10):1453-62
Publication Type
Article
Date
Oct-2003
Author
Anders Romelsjö
Maria Branting
Johan Hallqvist
Lars Alfredsson
Niklas Hammar
Anders Leifman
Anders Ahlbom
Author Affiliation
Centre for Social Research on Alcohol and Drugs, Stockholm, Sweden. anders.romelsjo@sorad.su.se
Source
Addiction. 2003 Oct;98(10):1453-62
Date
Oct-2003
Language
English
Publication Type
Article
Keywords
Aged
Alcohol drinking - epidemiology
Case-Control Studies
Female
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Occupational Health
Research Support, Non-U.S. Gov't
Social Support
Stress, Psychological - complications
Sweden - epidemiology
Temperance - statistics & numerical data
Abstract
AIMS: Very few studies indicating that low-moderate alcohol consumption protects from myocardial infarction (MI) controlled for social support and working conditions, which could confound the findings. Therefore, a first aim was to study the risk of non-fatal and total MI in relation to volume of alcohol consumption and measures of social support and working conditions. A second aim was to analyse the impact of the volume of earlier alcohol use in abstainers. DESIGN: Data came from a case-control study, the Stockholm Heart Epidemiology Program (SHEEP), including first MI among Swedish citizens 45-70 years old. SETTING: Stockholm County 1992-94. PARTICIPANTS: There were 1095 cases of MI in men and 471 in women (928 and 372 were non-fatal), and 2339 living controls from the general population. MEASUREMENT: Information about alcohol use at different periods in life and job strain, social anchorage and life control besides pre-existing health problems, smoking, physical activity, socio-economic status and marital status was obtained by a questionnaire from the cases and the controls. FINDINGS: In multivariate logistic regression analyses, the relative risk for MI (especially non-fatal) was reduced among alcohol consumers. RR for non-fatal MI was 0.52 (95% confidence intervals 0.32, 0.85) in men with a consumption of 50-69.9 g 100% ethanol/day and 0.21 (95% confidence interval 0.06, 0.77) in women with a consumption of 30 g or more per day (reference category 0.1-5 g 100% ethanol/day). Men who were abstainers during the previous 1-10 years and with an earlier average consumption of 5-30 g 100% ethanol/day had a significantly lower relative risk compared to such abstainers with an earlier higher consumption. Earlier consumption among abstainers may also have an impact on gender differences in MI. Analyses showed positive interaction between abstention and low life-control in women, but only 4% of the female cases were due to this interaction. There were no other interactions between measures of alcohol use and social anchorage, life control and working situations. CONCLUSION: Alcohol use had a protective impact on MI, with little impact of job strain, social anchorage and life control, giving increased support for a protective impact of low-moderate alcohol use. The level of previous alcohol consumption among male 1-10-year-long abstainers influenced the risk of MI.
PubMed ID
14519183 View in PubMed
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Adherence to a healthy Nordic food index and risk of myocardial infarction in middle-aged Danes: the diet, cancer and health cohort study.

https://arctichealth.org/en/permalink/ahliterature290731
Source
Eur J Clin Nutr. 2017 05; 71(5):652-658
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
05-2017
Author
V B Gunge
I Andersen
C Kyrø
C P Hansen
C C Dahm
J Christensen
A Tjønneland
A Olsen
Author Affiliation
Unit of Diet, Genes and Environment, Danish Cancer Society Research Centre, Copenhagen, Denmark.
Source
Eur J Clin Nutr. 2017 05; 71(5):652-658
Date
05-2017
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Cohort Studies
Denmark
Diet, Mediterranean
European Continental Ancestry Group
Female
Follow-Up Studies
Health Behavior
Healthy Diet
Humans
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Neoplasms - epidemiology - prevention & control
Patient compliance
Proportional Hazards Models
Prospective Studies
Risk factors
Abstract
For decades, the Mediterranean diet has been in focus regarding healthy eating as it has been associated with reduced risk of non-communicable diseases. Less interest has been given to health benefits of other regional diets. The aim of the present study was to assess whether adherence to a healthy Nordic food index was associated with lower risk of myocardial infarction (MI) among middle-aged Danes.
Data were obtained from the Danish Diet, Cancer and Health cohort study of 57?053 men and women aged 50-64 years recruited between 1993 and 1997. The healthy Nordic food index comprised healthy Nordic food items selected a priori (fish, cabbage, rye bread, oatmeal, apple and pears and root vegetables). Information on incident MI was ascertained through linkage with national registries. Hazard ratios (HR) with 95% confidence intervals (CI) were estimated from sex-specific Cox proportional hazard models.
In total, 1669 men and 653 women developed MI during follow-up (13.6 median years). In adjusted models, those with an index score of 5-6 points (highest scores) had significantly lower MI risk (men: HR=0.77, 95% CI=0.62, 0.97; women: HR=0.55, 95% CI=0.37, 0.82) relative to those scoring 0 points in the index (lowest score). A significantly lower MI risk was found per 1-point increment in the index in both men (HR=0.95, 95% CI=0.92, 0.99) and women (HR=0.93, 95% CI=0.88, 0.98).
A healthy Nordic diet is associated with lower MI risk among middle-aged Danes, suggesting that Nordic diets should be considered in recommendations for dietary changes in the promotion of coronary health.
PubMed ID
28247857 View in PubMed
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Aspirin-resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events.

https://arctichealth.org/en/permalink/ahliterature190662
Source
Circulation. 2002 Apr 9;105(14):1650-5
Publication Type
Article
Date
Apr-9-2002
Author
John W Eikelboom
Jack Hirsh
Jeffrey I Weitz
Marilyn Johnston
Qilong Yi
Salim Yusuf
Author Affiliation
Department of Medicine, University of Western Australia, Thrombosis and Haemophilia Unit, Royal Perth Hospital, Perth, Australia. john.eikelboom@health.wa.gov.au
Source
Circulation. 2002 Apr 9;105(14):1650-5
Date
Apr-9-2002
Language
English
Publication Type
Article
Keywords
Aged
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Aspirin - therapeutic use
Canada - epidemiology
Cardiovascular Diseases - drug therapy - epidemiology - metabolism
Case-Control Studies
Cohort Studies
Comorbidity
Cyclooxygenase Inhibitors - therapeutic use
Death, Sudden, Cardiac - epidemiology - prevention & control
Demography
Female
Follow-Up Studies
Humans
Male
Myocardial Infarction - epidemiology - prevention & control
Odds Ratio
Randomized Controlled Trials as Topic
Recurrence - prevention & control
Risk assessment
Risk factors
Stroke - epidemiology - prevention & control
Thromboxane B2 - analogs & derivatives - urine
Thromboxanes - biosynthesis - urine
Vitamin E - therapeutic use
Abstract
We studied whether aspirin resistance, defined as failure of suppression of thromboxane generation, increases the risk of cardiovascular events in a high-risk population.
Baseline urine samples were obtained from 5529 Canadian patients enrolled in the Heart Outcomes Prevention Evaluation (HOPE) Study. Using a nested case-control design, we measured urinary 11-dehydro thromboxane B2 levels, a marker of in vivo thromboxane generation, in 488 cases treated with aspirin who had myocardial infarction, stroke, or cardiovascular death during 5 years of follow-up and in 488 sex- and age-matched control subjects also receiving aspirin who did not have an event. After adjustment for baseline differences, the odds for the composite outcome of myocardial infarction, stroke, or cardiovascular death increased with each increasing quartile of 11-dehydro thromboxane B2, with patients in the upper quartile having a 1.8-times-higher risk than those in the lower quartile (OR, 1.8; 95% CI, 1.2 to 2.7; P=0.009). Those in the upper quartile had a 2-times-higher risk of myocardial infarction (OR, 2.0; 95% CI, 1.2 to 3.4; P=0.006) and a 3.5-times-higher risk of cardiovascular death (OR, 3.5; 95% CI, 1.7 to 7.4; P
Notes
Comment In: Circulation. 2002 Apr 9;105(14):1620-211940535
Comment In: Circulation. 2002 Apr 9;105(14):e9094-511942339
Comment In: Circulation. 2002 Dec 10;106(24):e200-1; author reply e200-112473569
Comment In: Circulation. 2002 Nov 26;106(22):e181-2; author reply e181-212451018
PubMed ID
11940542 View in PubMed
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Association between naproxen use and protection against acute myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature190150
Source
Arch Intern Med. 2002 May 27;162(10):1111-5
Publication Type
Article
Date
May-27-2002
Author
Elham Rahme
Louise Pilote
Jacques LeLorier
Author Affiliation
Division of Clinical Epidemiology, Montreal General Hospital, 1650 Cedar Ave, Room L10-408, Montreal, Quebec, Canada H3G 1A4. elham.rahme@mcgill.ca
Source
Arch Intern Med. 2002 May 27;162(10):1111-5
Date
May-27-2002
Language
English
Publication Type
Article
Keywords
Aged
Anti-Inflammatory Agents, Non-Steroidal - pharmacology - therapeutic use
Case-Control Studies
Cyclooxygenase Inhibitors - pharmacology - therapeutic use
Female
Hospitalization - statistics & numerical data
Humans
Incidence
Male
Matched-Pair Analysis
Myocardial Infarction - epidemiology - prevention & control
Naproxen - pharmacology - therapeutic use
Quebec - epidemiology
Risk
Abstract
The association between the use of nonsteroidal anti-inflammatory drugs (NSAIDs) and acute myocardial infarction (AMI) is unclear. Nonsteroidal anti-inflammatory drugs vary in their antithrombotic properties, with naproxen having a particularly effective antithrombotic potential.
To compare the effect of naproxen vs other NSAIDs in the prevention of AMI in an older population.
Population-based, matched case-control study. Patients (aged > or =65 years) in Quebec had been hospitalized for AMI between January 1, 1992, and December 31, 1994. The admission date for AMI was considered the index date. Control subjects were randomly selected from a Quebec drug and physician claims database. For each case, a control was matched with the same index date, age (within 2 years), and sex. Cases and controls were required to have at least 1 year of pharmaceutical and medical records before the index date to identify risk factors for AMI and exposure to naproxen or other nonaspirin NSAIDs. Concurrent exposure to a medication was defined as exposure to that medication at the index date. Logistic regression analyses were used to evaluate the association between the use of naproxen and other NSAIDs in the prevention of AMI, adjusting for potential confounders.
Included in the study were 4163 cases and 14 160 controls. Determinants (adjusted odds ratios [95% confidence intervals]) of AMI included use in the prior year of anticoagulants (0.76 [0.64-0.90]), nitrates (2.01 [1.86-2.17]), antidiabetic agents (1.72 [1.56-1.90]), antihypertensive agents (1.36 [1.28-1.45]), and lipid-lowering agents (0.83 [0.75-0.91]), as well as concurrent exposure to naproxen vs other NSAIDs (0.79 [0.63-0.99]).
Compared with other NSAIDs, concurrent exposure to naproxen has a protective effect against AMI.
Notes
Comment In: Arch Intern Med. 2002 Dec 9-23;162(22):2639-40; author reply 2640-212456259
Comment In: Arch Intern Med. 2002 Dec 9-23;162(22):2639; author reply 2640-212456258
Comment In: Arch Intern Med. 2002 May 27;162(10):1091-212020175
Erratum In: Arch Intern Med 2002 Sep 9;162(16):1858
PubMed ID
12020180 View in PubMed
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Beta blockers for elective surgery in elderly patients: population based, retrospective cohort study.

https://arctichealth.org/en/permalink/ahliterature172521
Source
BMJ. 2005 Oct 22;331(7522):932
Publication Type
Article
Date
Oct-22-2005
Author
Donald Redelmeier
Damon Scales
Alexander Kopp
Author Affiliation
Sunnybrook and Women's College Health Sciences Centre, G-151, 2075 Bayview Ave, Ontario, Canada M4N 3M5. DAR@ICES.ON.CA
Source
BMJ. 2005 Oct 22;331(7522):932
Date
Oct-22-2005
Language
English
Publication Type
Article
Keywords
Adrenergic beta-Antagonists - therapeutic use
Aged
Atenolol - therapeutic use
Canada - epidemiology
Female
Hospital Mortality
Humans
Male
Metoprolol - therapeutic use
Myocardial Infarction - epidemiology - prevention & control
Perioperative Care - methods
Postoperative Complications - prevention & control
Retrospective Studies
Surgical Procedures, Elective
Abstract
To test whether atenolol (a long acting beta blocker) and metoprolol (a short acting beta blocker) are associated with equivalent reductions in risk for elderly patients undergoing elective surgery.
Population based, retrospective cohort analysis.
Acute care hospitals in Ontario, Canada, over one decade.
Consecutive patients older than 65 who were admitted for elective surgery, without symptomatic coronary disease.
Death or myocardial infarction.
37,151 patients were receiving atenolol or metoprolol before surgery, of which the most common operations were orthopaedic or abdominal procedures. As expected, the two groups were similar in demographic characteristics, medical therapy, and type of surgery. 1038 patients experienced a myocardial infarction or died, a rate that was significantly lower for patients receiving atenolol than for those receiving metoprolol (2.5% v 3.2%, P
Notes
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Comment In: BMJ. 2005 Oct 22;331(7522):919-2016239671
PubMed ID
16210252 View in PubMed
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Characteristics of smokers and long-term changes in smoking behavior in consecutive patients with myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature54002
Source
Prev Med. 2000 Dec;31(6):732-41
Publication Type
Article
Date
Dec-2000
Author
T F van Berkel
M J van der Vlugt
H. Boersma
Author Affiliation
Thoraxcenter, University Hospital Rotterdam, The Netherlands. vanberkel@card.azr.nl
Source
Prev Med. 2000 Dec;31(6):732-41
Date
Dec-2000
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Attitude to Health
Comparative Study
Female
Health Behavior
Health Surveys
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Norway - epidemiology
Predictive value of tests
Proportional Hazards Models
Reference Values
Registries
Risk factors
Smoking - adverse effects - epidemiology
Smoking Cessation - statistics & numerical data
Statistics, nonparametric
Survival Rate
Abstract
BACKGROUND: The prognosis of patients with estabLished coronary artery improves if smoking is stopped. Still, about half of patients who suffer a myocardial infarction continue smoking after that event. In order to predict to whom additional support should be offered, various baseline characteristics were compared with smoking status at short-term and long-term follow-up. METHODS: Demographics, medical history, presence of coronary risk factors, psychological determinants, and the clinical course were recorded in a group of 530 unselected consecutive patients who had been admitted with a myocardial infarction and were smoking. Patients who were smoking at admission, and who were alive at 4-year follow-up, were studied to relate smoking status and baseline characteristics. RESULTS: At 3 months, persistent smokers were younger than quitters, had shorter hospital stays, underwent revascularization procedures less often, smoked more cigarettes per day at baseline, and were more socially isolated. After 4 years, patients who stopped smoking had had a more serious myocardial infarction and had a lower displeasure score than those who continued smoking. Also, quitters received more support from their social environment. CONCLUSIONS: Although the majority of the patients try to stop smoking after a myocardial infarction, about half smokes after 4 years. In the future, special support should be offered to smokers who suffer myocardial infarction, especially to those whose psychosocial profiles are less favorable.
PubMed ID
11133341 View in PubMed
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Chocolate consumption and risk of myocardial infarction: a prospective study and meta-analysis.

https://arctichealth.org/en/permalink/ahliterature284049
Source
Heart. 2016 Jul 01;102(13):1017-22
Publication Type
Article
Date
Jul-01-2016
Author
Susanna C Larsson
Agneta Åkesson
Bruna Gigante
Alicja Wolk
Source
Heart. 2016 Jul 01;102(13):1017-22
Date
Jul-01-2016
Language
English
Publication Type
Article
Keywords
Aged
Chocolate - statistics & numerical data
Diet Surveys
Feeding Behavior
Female
Follow-Up Studies
Humans
Incidence
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Prospective Studies
Risk Assessment - methods
Sweden - epidemiology
Abstract
To examine whether chocolate consumption is associated with a reduced risk of ischaemic heart disease, we used data from a prospective study of Swedish adults and we performed a meta-analysis of available prospective data.
The Swedish prospective study included 67 640 women and men from the Cohort of Swedish Men and the Swedish Mammography Cohort who had completed a food-frequency questionnaire and were free of cardiovascular disease at baseline. Myocardial infarction (MI) cases were ascertained through linkage with the Swedish National Patient and Cause of Death Registers. PubMed and EMBASE databases were searched from inception until 4 February 2016 to identify prospective studies on chocolate consumption and risk of ischaemic heart disease.
The results from eligible studies were combined using a random-effects model. During follow-up (1998-2010), 4417 MI cases were ascertained in the Swedish study. Chocolate consumption was inversely associated with MI risk. Compared with non-consumers, the multivariable relative risk for those who consumed =3-4 servings/week of chocolate was 0.87 (95% CI 0.77 to 0.98; p for trend =0.04). Five prospective studies on chocolate consumption and ischaemic heart disease were identified. Together with the Swedish study, the meta-analysis included six studies with a total of 6851 ischaemic heart disease cases. The overall relative risk for the highest versus lowest category of chocolate consumption was 0.90 (95% CI 0.82 to 0.97), with little heterogeneity among studies (I(2)=24.3%).
Chocolate consumption is associated with lower risk of MI and ischaemic heart disease.
PubMed ID
26936339 View in PubMed
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Daily intake of magnesium and calcium from drinking water in relation to myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature47035
Source
Epidemiology. 2005 Jul;16(4):570-6
Publication Type
Article
Date
Jul-2005
Author
Mats Rosenlund
Niklas Berglind
Johan Hallqvist
Tom Bellander
Gösta Bluhm
Author Affiliation
Department of Occupational and Environmental Health, Stockholm County Council, Stockholm, Sweden. mats.rosenlund@sll.se
Source
Epidemiology. 2005 Jul;16(4):570-6
Date
Jul-2005
Language
English
Publication Type
Article
Keywords
Aged
Calcium, Dietary - administration & dosage - analysis
Case-Control Studies
Catchment Area (Health)
Drinking
Female
Humans
Logistic Models
Magnesium - administration & dosage - analysis
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Questionnaires
Risk factors
Sweden - epidemiology
Water Supply - analysis
Abstract
BACKGROUND: A decreased risk for cardiovascular disease has been related to the hardness of drinking water, particularly high levels of magnesium. However, the evidence is still uncertain, especially in relation to individual intake from water. METHODS: We used data from the Stockholm Heart Epidemiology Program, a population-based case-control study conducted during 1992-1994, to study the association between myocardial infarction and the daily intake of drinking water magnesium and calcium. Our analyses are based on 497 cases age 45-70 years, and 677 controls matched on age, sex, and hospital catchment area. Individual data on magnesium, calcium, and hardness of the domestic drinking water were assessed from waterwork registers or analyses of well water. RESULTS: After adjustment for the matching variables and smoking, hypertension, socioeconomic status, job strain, body mass index, diabetes, and physical inactivity, the odds ratio for myocardial infarction was 1.09 (95% confidence interval = 0.81-1.46) associated with a tap water hardness above the median (>4.4 German hardness degrees) and 0.88 (0.67-1.15) associated with a water magnesium intake above the median (>1.86 mg/d). There was no apparent sign of any exposure-response pattern related to water intake of magnesium or calcium. CONCLUSIONS: This study does not support previous reports of a protective effect on myocardial infarction associated with consumption of drinking water with higher levels of hardness, magnesium, or calcium.
PubMed ID
15951677 View in PubMed
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Dietary intake of n-3 long-chain polyunsaturated fatty acids and risk of myocardial infarction in coronary artery disease patients with or without diabetes mellitus: a prospective cohort study.

https://arctichealth.org/en/permalink/ahliterature106813
Source
BMC Med. 2013;11:216
Publication Type
Article
Date
2013
Author
Elin Strand
Eva R Pedersen
Gard F T Svingen
Hall Schartum-Hansen
Eirik W Rebnord
Bodil Bjørndal
Reinhard Seifert
Pavol Bohov
Klaus Meyer
J Kalervo Hiltunen
Jan E Nordrehaug
Dennis W T Nilsen
Rolf K Berge
Ottar Nygård
Author Affiliation
Department of Clinical Science, University of Bergen, 5021 Bergen, Norway. Elin.Strand@med.uib.no.
Source
BMC Med. 2013;11:216
Date
2013
Language
English
Publication Type
Article
Keywords
Aged
Cohort Studies
Coronary Artery Disease - epidemiology - prevention & control
Diabetes Mellitus - epidemiology
Fatty Acids, Omega-3 - administration & dosage
Female
Fish Oils - administration & dosage
Folic Acid - administration & dosage
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Norway - epidemiology
Prospective Studies
Risk factors
Seafood
Abstract
A beneficial effect of a high n-3 long-chain polyunsaturated fatty acid (LCPUFA) intake has been observed in heart failure patients, who are frequently insulin resistant. We investigated the potential influence of impaired glucose metabolism on the relation between dietary intake of n-3 LCPUFAs and risk of acute myocardial infarction (AMI) in patients with coronary artery disease.
This prospective cohort study was based on the Western Norway B-Vitamin Intervention Trial and included 2,378 patients with coronary artery disease with available baseline glycosylated hemoglobin (HbA1c) and dietary data. Patients were sub-grouped as having no diabetes (HbA1c
Notes
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PubMed ID
24103380 View in PubMed
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Dietary non enzymatic antioxidant capacity and the risk of myocardial infarction in the Swedish women's lifestyle and health cohort.

https://arctichealth.org/en/permalink/ahliterature297934
Source
Eur J Epidemiol. 2018 02; 33(2):213-221
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Date
02-2018
Author
Essi Hantikainen
Marie Löf
Alessandra Grotta
Ylva Trolle Lagerros
Mauro Serafini
Rino Bellocco
Elisabete Weiderpass
Author Affiliation
Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Edificio U7, Via Bicocca degli Arcimboldi 8, 20126, Milan, Italy.
Source
Eur J Epidemiol. 2018 02; 33(2):213-221
Date
02-2018
Language
English
Publication Type
Journal Article
Research Support, Non-U.S. Gov't
Keywords
Adult
Antioxidants - administration & dosage - metabolism
Cohort Studies
Diet
Female
Fruit
Humans
Incidence
Life Style
Middle Aged
Myocardial Infarction - epidemiology - prevention & control
Proportional Hazards Models
Sweden - epidemiology
Vegetables
Abstract
Foods rich in antioxidants have been associated with a reduced risk of myocardial infarction. However, findings from randomized clinical trials on the role of antioxidant supplementation remain controversial. It has been suggested that antioxidants interact with each other to promote cardiovascular health. We therefore investigated the association between dietary Non Enzymatic Antioxidant Capacity (NEAC), measuring the total antioxidant potential of the whole diet, and the risk of myocardial infarction. We followed 45,882 women aged 30-49 years and free from cardiovascular diseases through record linkages from 1991 until 2012. Dietary NEAC was assessed by a validated food frequency questionnaire collected at baseline. Total dietary NEAC was categorized into quintiles and multivariable Cox proportional hazard regression models were fitted to estimate hazard ratios (HR) with 95% confidence intervals (CI). During a mean follow-up time of 20.3 years we detected 657 incident cases of myocardial infarction. After adjusting for potential confounders, we found a significant 28% lower risk of myocardial infarction among women in the fourth (HR: 0.72; 95% CI 0.55-0.95) and a 40% lower risk among women in the fifth quintile (HR: 0.60, 95% CI 0.45-0.81) of dietary NEAC compared to women in the first quintile, with a significant trend (p-value 
PubMed ID
29372463 View in PubMed
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