Kjeldsen Emilie W, Thomassen Jesper Q, Rasmussen Katrine L, Nordestgaard Børge G, Tybjærg-Hansen Anne, Frikke-Schmidt Ruth
Department of Clinical Biochemistry, Copenhagen University Hospital - Rigshospitalet, Blegdamsvej 9, Copenhagen 2100, Denmark.
Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3, Copenhagen 2200, Denmark.
Lancet Reg Health Eur. 2022 May 28;19:100419. doi: 10.1016/j.lanepe.2022.100419. eCollection 2022 Aug.
An unhealthy diet is a major risk factor for cardiovascular disease attributing to the burden of non-communicable diseases. Current dietary guidelines are not sufficiently implemented and effective strategies to encourage people to change and maintain healthy diets are lacking. We aimed to evaluate the impact of incorporating dietary assessment into ten-year absolute risk charts for atherosclerotic cardiovascular disease (ASCVD).
In the prospective Copenhagen General Population Study including 94 321 individuals, we generated sex-specific ten-year absolute risk scores for ASCVD according to adherence to dietary guidelines, using a short and valid food frequency questionnaire. To account for competing risk, we used the method of Fine-Gray.
Non-adherence to dietary guidelines was associated with an atherogenic lipid and inflammatory profile. Ten-year absolute risk of ASCVD increased with increasing age, increasing systolic blood pressure, and decreasing adherence to dietary guidelines for both sexes. The highest ten-year absolute risk of ASCVD of 38% was observed in men aged 65-69 years who smoked, had very low adherence to dietary guidelines, and a systolic blood pressure between 160 and 179 mmHg. The corresponding value for women was 26%. Risk charts replacing dietary assessment with non-HDL cholesterol yielded similar estimates.
Incorporation of a short dietary assessment into ten-year absolute risk charts has the potential to motivate patients to adhere to dietary guideline recommendations. Improved implementation of national dietary guidelines must be a cornerstone for future prevention of cardiovascular disease in both younger and older individuals.
The Lundbeck Foundation (R278-2018-804) and the Danish Heart Foundation.
不健康饮食是心血管疾病的主要危险因素，这归因于非传染性疾病的负担。当前的饮食指南未得到充分实施，且缺乏鼓励人们改变并维持健康饮食的有效策略。我们旨在评估将饮食评估纳入动脉粥样硬化性心血管疾病（ASCVD）十年绝对风险图表的影响。
在一项纳入94321人的前瞻性哥本哈根普通人群研究中，我们使用简短且有效的食物频率问卷，根据对饮食指南的遵守情况生成了特定性别的ASCVD十年绝对风险评分。为了考虑竞争风险，我们使用了Fine-Gray方法。
不遵守饮食指南与致动脉粥样硬化的血脂和炎症特征相关。对于男女而言，ASCVD的十年绝对风险均随着年龄增长、收缩压升高以及饮食指南遵守程度降低而增加。在65 - 69岁吸烟、饮食指南遵守程度极低且收缩压在160至179 mmHg之间的男性中，观察到ASCVD的最高十年绝对风险为38%。女性的相应值为26%。用非高密度脂蛋白胆固醇替代饮食评估的风险图表得出了类似的估计值。
将简短的饮食评估纳入十年绝对风险图表有可能促使患者遵守饮食指南建议。改善国家饮食指南的实施必须成为未来预防年轻人和老年人心血管疾病的基石。
伦贝克基金会（R278 - 2018 - 804）和丹麦心脏基金会。
