Dietary patterns and mortality risk in geriatric patients with atherosclerotic cardiovascular disease: an analysis of the National Health and Nutrition Examination Survey.

Atherosclerotic cardiovascular disease (ASCVD) has a high incidence and a significant impact on quality of life, especially in older adults. Healthy diets potentially improve patient outcomes, but the most beneficial dietary pattern remains unclear. Therefore, we aimed to evaluate the effectiveness of different dietary patterns in improving outcomes for geriatric patients with ASCVD. This study used data from the National Health and Nutrition Examination Survey (NHANES) database (2003-2006) on older adults (≥ 60 years). Scores for the Healthy Eating Index 2015 (HEI-2015) diet, Mediterranean-style diet (MED), Dietary Approaches to Stop Hypertension (DASH), and Mediterranean-DASH intervention for neurodegenerative delay (MIND) diet were calculated. Cox proportional hazard models assessed the associations of different dietary patterns with all-cause and cardiovascular (CV) deaths in patients with ASCVD. The total population included 674 patients, including 453 (67.21%) all-cause deaths and 186 (27.60%) CV deaths, with a mean follow-up time of 117.5 months. Greater adherence to the MIND diet was associated with a lower risk of all-cause mortality (adjusted HR = 0.75, 95%CI:0.58, 0.96, P for trend = 0.016), whereas other dietary patterns had no significant associations (all P values > 0.05). No dietary pattern was significantly associated with CV mortality (all P values > 0.05). Moreover, the MIND diet significantly interacted with the inflammatory status in predicting all-cause mortality (P for interaction < 0.05). For older ASCVD patients, higher adherence to the MIND diet is associated with reduced all-cause mortality, with inflammation significantly modulating this effect. The MIND diet may be the most beneficial eating pattern for this population.