title: Mediterranean-style diet is associated with reduced blood pressure variability and subsequent stroke risk in patients with coronary artery disease.
abstract: OBJECTIVE
  The Mediterranean-style diet is widely advocated for the prevention of cardiovascular diseases (CVD). Meanwhile, blood pressure variability (BPV) is a novel risk factor for CVD. It is unknown whether dietary pattern plays a role in modulating BPV.
  
  
  METHODS
  We prospectively followed-up 274 consecutive patients with stable coronary artery disease (CAD). The Mediterranean diet score (MDS) was derived for all individuals upon recruitment, blood pressure (BP) was measured during each subsequent clinic visit and the visit-to-visit BPV was calculated. The occurrence of major adverse cardiovascular events (MACEs) and all-cause mortality was monitored.
  
  
  RESULTS
  After a mean follow-up of 77±12 months, 16.1% of the study population developed MACEs. About 11.3% died from all causes. Patients who developed MACEs or all-cause mortality had a greater systolic BPV compared to those who did not develop an adverse event. Patients who developed a MACE had a lower MDS and further analysis revealed those who developed a stroke had a lower MDS compared with those who did not develop a stroke, but there were no significant differences in MDS between CAD patients with or without subsequent acute coronary syndrome, cardiovascular, or all-cause mortality. After adjusting for confounding variables, a high MDS was an independent predictor for low systolic BPV (B -0.74, 95% confidence interval -1.27 to -0.21, P < 0.01) and was noted to be protective against subsequent development of stroke (hazards ratio 0.48, 95% confidence interval 0.24 to 0.94, P = 0.03).
  
  
  CONCLUSIONS
  Among patients with CAD, a higher MDS is associated with a lower visit-to-visit BPV and with lower stroke risk.
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Kui-Kai
authors.initials: KK
authors.lastname: Lau
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Yuen-Kwun
authors.initials: YK
authors.lastname: Wong
authors.affiliation: Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: Yap-Hang
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Oi-Yi
authors.initials: OY
authors.lastname: Li
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Philip Yat-Sing
authors.initials: PY
authors.lastname: Lee
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Gabrielle G
authors.initials: GG
authors.lastname: Yuen
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Yee-Kiu
authors.initials: YK
authors.lastname: Wong
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Samuel
authors.initials: S
authors.lastname: Tong
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Dicken
authors.initials: D
authors.lastname: Wong
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Koon-Ho
authors.initials: KH
authors.lastname: Chan
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Raymond Tak-Fai
authors.initials: RT
authors.lastname: Cheung
authors.affiliation: Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong.
authors.forename: Chung-Wah
authors.initials: CW
authors.lastname: Siu
authors.affiliation: Neurology Division, Department of Medicine, The University of Hong Kong, Hong Kong;
authors.forename: Shu-Leong
authors.initials: SL
authors.lastname: Ho
authors.affiliation: Cardiology Division, Department of Medicine, The University of Hong Kong, Hong Kong. hftse@hkucc.hku.hk.
authors.forename: Hung-Fat
authors.initials: HF
authors.lastname: Tse
mesh_terms: D000368:Aged; D001794:Blood Pressure; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000401:mortality / Q000503:physiopathology; D038441:Diet, Mediterranean; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000178:diet therapy* / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D065840:Protective Factors; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000401:mortality / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Mediterranean-style diet; blood pressure; blood pressure variability; coronary artery disease; hypertension; stroke.