title: Diet, lipoproteins and the progression of coronary atherosclerosis. The Leiden Intervention Trial.
abstract: The relationship between diet, serum lipoproteins, and the progression of coronary lesions was studied in 39 patients with stable angina pectoris in whom coronary arteriography had shown at least 1 vessel with 50% obstruction before intervention. Intervention consisted of a 2-year vegetarian diet that had a ratio of polyunsaturated to saturated fatty acids of at least 2.0, and that contained less than 100mg of cholesterol per day. Dietary changes were associated with a significant increase in linoleic acid content of cholesterol esters and a significant lowering of bodyweight, systolic blood pressure, serum total cholesterol, and the ratio of total to high density lipoprotein (total/HDL) cholesterol. Angiographic examination was performed after 24 months; angiograms were assessed visually (with blinding) and by computer-assisted image analysis. Both types of assessment indicated progression of disease in 21 of 39 patients but no lesion growth in 18. Coronary lesion growth correlated with total/HDL cholesterol (r = 0.50, p = 0.001) but not with blood pressure, smoking status, alcohol intake, weight, or drug treatment. Disease progression was significant in patients who had values for total/HDL cholesterol that were higher than the median (greater than 6.9) throughout the trial period. No coronary lesion growth was observed in patients who had lower values for total/HDL cholesterol (less than 6.9) throughout the trial or who initially had higher values (greater than 6.9) that were significantly lowered by dietary intervention.
mesh_terms: D000787:Angina Pectoris / Q000178:diet therapy; D001161:Arteriosclerosis / Q000178:diet therapy / Q000473:pathology / Q000517:prevention & control*; D001835:Body Weight; D008076:Cholesterol, HDL / Q000032:analysis; D003327:Coronary Disease / Q000178:diet therapy / Q000473:pathology / Q000517:prevention & control*; D004032:Diet; D004041:Dietary Fats / Q000032:analysis; D005231:Fatty Acids, Unsaturated / Q000032:analysis; D006801:Humans; D008074:Lipoproteins / Q000097:blood; D009426:Netherlands
chemical_list: D008076:Cholesterol, HDL; D004041:Dietary Fats; D005231:Fatty Acids, Unsaturated; D008074:Lipoproteins