reduces recurrence of stroke

Joint photo of the team from IMIBIC, HURS, UCO and Ciberob, who have carried out the research published in The Lancet.

Internal medicine doctors Spanish Society of Internal Medicine (SEMI) have published in the prestigious British scientific journal The Lancet a scientific article that under the title “Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (Cordioprev): a randomized controlled trial” that demonstrates for the first time that “The Mediterranean diet prevents the recurrence of cardiovascular events versus a low-fat diet.

The low-fat diet (rich in complex carbohydrates) and the Mediterranean diet (rich in monounsaturated fat whose main source is virgin olive oil), have proven to be effective in primary prevention of high-risk patients without developed cardiovascular disease. However, the Mediterranean diet had not shown, until the publication of this study in The Lancet, beneficial effects on health in patients with established cardiovascular disease, compared to another heart-healthy diet such as the low-fat diet. as collected The Lancet, the Cordioprev study can be considered the only trial in the last 23 years that reliably evaluates the effect of the mediterranean diet in secondary prevention of cardiovascular disease.

Multi-agency scientific collaboration

This study has been jointly developed and promoted at a scientific level between the Maimonides Institute for Biomedical Research of Córdoba (IMIBIC), the Reina Sofía University Hospital (HURS), the University of Córdoba (UCO) and Ciberobn. “It represents a milestone in creating new scientific evidence and demonstrate that the Mediterranean diet rich in olive oil is useful to prevent new cardiovascular events in people with established coronary disease”, says Pablo Pérez Martínez, Scientific Director of IMIBIC and internal medicine member of SEMI.

To demonstrate this, ‘Cordioprev’ has been developed, a randomized clinical trial conducted at HURS. In it, they participated 1,002 patients with established coronary artery disease aged between 20 and 76 years, who received dietary intervention with Mediterranean diet or low-fat diet and were followed for seven years. A total of 500 (49.9 percent) of the 1,002 patients were assigned to the low-fat diet group and 502 (50.1 percent) to the Mediterranean diet group.

As main research objectives, the following were established: “assess the appearance of new cardiovascular events majors (or main event), including myocardial infarctionrevascularization (bypass, catheterizations, stents), Ischemic stroke (ictus), peripheral arterial disease, and cardiovascular death (sudden death)”. The appearance of these events was evaluated with the two types of diet followed by the patients, recruited between October 2009 and February 2012.

What effects did the Mediterranean diet generate in coronary patients?

The research participants had a mean age of 59.5 years, and, as usual regarding the incidence of coronary disease, they were mostly male (82.5 percent). The primary event of the study occurred in 198 participants, 87 in the Mediterranean diet (17.3 percent) and 111 in the low-fat diet (22.2 percent), which represents a 25 to 30 percent decrease in frequency approximately, in the participants who followed the Mediterranean diet.

These effects were more evident in men, where the difference between diets was almost 35 in favor of the Mediterranean diet. It should be noted that the incidence found in the two arms of the study is lower than usual in this type of patient (25% at 5 years), which could indicate that, despite the differences found, both diets exerted heart-healthy effects.

“These results are useful to be able to change the clinical guidelines on dietary recommendations and follow-up of patients with coronary heart disease”

An “enormous” relevance for daily clinical practice

López Miranda, head of the Internal Medicine Service at the Reina Sofía University Hospital and principal investigator of the Project, points out that “the Cordioprev study demonstrates in patients with established coronary artery disease that the Mediterranean diet had a greater effect than the low-fat diet in the prevention of the occurrence of recurrent cardiovascular events such as myocardial infarction, revascularization, ischemic stroke, peripheral arterial disease and cardiovascular death avoiding the occurrence of one in four major cardiovascular events”.

These findings, says Delgado Lista, first author of the article and professor at the University of Córdoba, “are enormous relevance for daily clinical practice, supporting the use of the Mediterranean diet to prevent the recurrence of cardiovascular disease and demonstrate the usefulness of recommending this type of diet to people who have previously had a cardiovascular event.” In this way, in the scientific article itself it is indicated that these results are utility to be able to “change the clinical guidelines on dietary recommendations and follow-up of patients with coronary heart disease”.

Cardiovascular disease remains one of the first causes of mortality and health spending both in Spain and in Europe. Lifestyle is a key factor to modify to prevent the incidence and recurrence of cardiovascular events, along with drugs and other procedures, such as revascularization techniques.

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