DASH Score and Subsequent Risk of Coronary Artery Disease: The Findings From Million Veteran Program

• Type of Material: Article
• Authors: Luc Djousse, Boston VA Healthcare Syst; Yuk‐Lam Ho, Boston VA Healthcare Syst; Xuan‐Mai T. Nguyen, Boston VA Healthcare Syst; David R. Gagnon, Boston VA Healthcare Syst; Peter W Wilson, Emory University; Kelly Cho, Boston VA Healthcare Syst; J. Michael Gaziano, Boston VA Healthcare Syst; Veteran Program VA Million, Boston VA Healthcare Syst
• Language: English
• Date: 2018-05-01
• Publisher: Wiley Open Access: Creative Commons Attribution Non-Commercial
• Publication Version: Final Published Version
• Copyright Statement: © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1161/JAHA.117.008089
• Title of Journal or Parent Work: Journal of the American Heart Association
• ISSN: 2047-9980
• Volume: 7
• Issue: 9
• Start Page: e008089
• End Page: e008089
• Grant/Funding Information: This research is based on data from the Million Veteran Program, Office of Research and Development, Veterans Health Administration, and was supported by award CSP# G002.; This research was also supported by the VA Merit Award I01‐CX001025.
• Keywords: Science & Technology; CHILDHOOD METABOLIC SYNDROME; BLOOD-PRESSURE; DIETARY PATTERNS; Life Sciences & Biomedicine; MORTALITY; nutrition; IDEAL CARDIOVASCULAR HEALTH; POPULATION; OVER CLINICAL-TRIAL; AMERICAN-HEART-ASSOCIATION; Cardiac & Cardiovascular Systems; HYPERTENSION; epidemiology; METAANALYSIS; coronary artery disease; Cardiovascular System & Cardiology
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Public Health; Health Sciences, Epidemiology

Abstract

Background--While adherence to healthful dietary patterns has been associated with a lower risk of coronary artery disease (CAD) in the general population, limited data are available among US veterans. We tested the hypothesis that adherence to Dietary Approach to Stop Hypertension (DASH) food pattern is associated with a lower risk of developing CAD among veterans. Methods and Results--We analyzed data on 153 802 participants of the Million Veteran Program enrolled between 2011 and 2016. Information on dietary habits was obtained using a food frequency questionnaire at enrollment. We used electronic health records to assess the development of CAD during follow-up. Of the 153 802 veterans who provided information on diet and were free of CAD at baseline, the mean age was 64.0 (SD=11.8) years and 90.4% were men. During a mean follow-up of 2.8 years, 5451 CAD cases occurred. The crude incidence rate of CAD was 14.0, 13.1, 12.6, 12.3, and 11.1 cases per 1000 person-years across consecutive quintiles of Dietary Approach to Stop Hypertension score. Hazard ratios (95% confidence interval) for CAD were 1.0 (ref), 0.91 (0.84-0.99), 0.87 (0.80-0.95), 0.86 (0.79-0.94), and 0.80 (0.73-0.87) from the lowest to highest quintile of Dietary Approach to Stop Hypertension score controlling for age, sex, body mass index, race, smoking, exercise, alcohol intake, and statin use (P linear trend, <0.0001). Conclusions--Our data are consistent with an inverse association between Dietary Approach to Stop Hypertension diet score and incidence of CAD among US veterans.