[Nutritional aspects of cardiovascular prevention].
An outline of the points of impact of atherothrombosis on pathophysiological processes is followed by a review of nutritional trials concerning the prevention and regression of atherosclerosis. Unifactorial primary prevention studies, although favourable overall, are subject to methodological criticisms and would require far larger cohorts before conclusions can be drawn. Multifactorial primary prevention studies show evidence of efficacy proportional to the reduction in risk factors obtained. The OSLO study is the most conclusive in this respect. Secondary prevention studies concern patients with coronary disease or infarct survivors. They are extremely heterogeneous. Certain involve nutritional supplements in addition. Others, such as the Renaud study based upon a mediterranean-type diet, are spectacular. Trials of the prevention by n-3 fatty acids of restenosis after transluminal coronary angioplasty are also analysed: 5 out of 8 were effective. All studies devoted to the regression of atherosclerosis have revealed less progression or regression of the disease following nutritional measures, on the basis of both clinical and angiographic parameters. The role of nutrition in the prevention and treatment of atherothrombosis is worthy of greater consideration on a first-line basis, before being completed by drug treatment, the efficacy of which is then enhanced.
Service de Nutrition, Institut Pasteur de Lille.
J M
JM
Lecerf
D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000517:prevention & control*; D004036:Diet, Atherogenic; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D008297:Male
Aspects nutritionnels de la prévention cardio-vasculaire.