DASH score and subsequent risk of coronary artery disease: The findings from million veteran program

on behalf of the VA Million Veteran Program

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Article numbere008089
JournalJournal of the American Heart Association
Volume7
Issue number9
DOIs
StatePublished - May 1 2018

Fingerprint

Veterans
Coronary Artery Disease
Hypertension
Diet
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Food
Electronic Health Records
Incidence
Feeding Behavior
Body Mass Index
Smoking
Alcohols
Confidence Intervals
Exercise
Population

Keywords

  • Coronary artery disease
  • Epidemiology
  • Nutrition

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

DASH score and subsequent risk of coronary artery disease : The findings from million veteran program. / on behalf of the VA Million Veteran Program.

In: Journal of the American Heart Association, Vol. 7, No. 9, e008089, 01.05.2018.

Research output: Contribution to journalArticle

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title = "DASH score and subsequent risk of coronary artery disease: The findings from million veteran program",
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.",
keywords = "Coronary artery disease, Epidemiology, Nutrition",
author = "{on behalf of the VA Million Veteran Program} and Luc Djouss{\'e} and Ho, {Yuk Lam} and Nguyen, {Xuan Mai T.} and Gagnon, {David R.} and Wilson, {Peter W.F.} and Kelly Cho and {Michael Gaziano}, J. and Ildiko Halasz and Daniel Federman and Jean Beckham and Scott Sherman and Peruvemba Sriram and Tsao, {Philip S.} and Boyko, {Edward J.} and Junzhe Xu and Frank Lederle and Dellitalia, {Louis J.} and Rachel McArdle and Laurence Kaminsky and DeBakey, {Michael E.} and Swann, {Alan C.} and Hamner, {Mark B.} and Florez, {Hermes J.} and Prashant Pandya and Gerardo Villarreal and Peter Wilson and Morgan, {Timothy R.} and Lori Davis and Bill, {W. G.} and Hurley, {Robin A.} and Laurence Meyer and Ahuja, {Sunil K.} and Konicki, {Eric P.} and David Cohen and Jack Lichy and Jeffrey Whittle and Haddock, {Kathlyn Sue} and Straub, {Karl D.} and Callaghan, {John T.} and Aguayo, {Samuel M.} and Samir Gupta and Washburn, {Ronald G.} and Oehlert, {Mary E.} and Hung, {Adriana M.} and Agnes Wallbom and Robert Keith and Elif Sonel and Schifman, {Ronald B.} and Childress, {Richard D.} and Godschalk, {Michael F.}",
year = "2018",
month = "5",
day = "1",
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language = "English (US)",
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TY - JOUR

T1 - DASH score and subsequent risk of coronary artery disease

T2 - The findings from million veteran program

AU - on behalf of the VA Million Veteran Program

AU - Djoussé, Luc

AU - Ho, Yuk Lam

AU - Nguyen, Xuan Mai T.

AU - Gagnon, David R.

AU - Wilson, Peter W.F.

AU - Cho, Kelly

AU - Michael Gaziano, J.

AU - Halasz, Ildiko

AU - Federman, Daniel

AU - Beckham, Jean

AU - Sherman, Scott

AU - Sriram, Peruvemba

AU - Tsao, Philip S.

AU - Boyko, Edward J.

AU - Xu, Junzhe

AU - Lederle, Frank

AU - Dellitalia, Louis J.

AU - McArdle, Rachel

AU - Kaminsky, Laurence

AU - DeBakey, Michael E.

AU - Swann, Alan C.

AU - Hamner, Mark B.

AU - Florez, Hermes J.

AU - Pandya, Prashant

AU - Villarreal, Gerardo

AU - Wilson, Peter

AU - Morgan, Timothy R.

AU - Davis, Lori

AU - Bill, W. G.

AU - Hurley, Robin A.

AU - Meyer, Laurence

AU - Ahuja, Sunil K.

AU - Konicki, Eric P.

AU - Cohen, David

AU - Lichy, Jack

AU - Whittle, Jeffrey

AU - Haddock, Kathlyn Sue

AU - Straub, Karl D.

AU - Callaghan, John T.

AU - Aguayo, Samuel M.

AU - Gupta, Samir

AU - Washburn, Ronald G.

AU - Oehlert, Mary E.

AU - Hung, Adriana M.

AU - Wallbom, Agnes

AU - Keith, Robert

AU - Sonel, Elif

AU - Schifman, Ronald B.

AU - Childress, Richard D.

AU - Godschalk, Michael F.

PY - 2018/5/1

Y1 - 2018/5/1

N2 - 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.

AB - 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.

KW - Coronary artery disease

KW - Epidemiology

KW - Nutrition

UR - http://www.scopus.com/inward/record.url?scp=85046480021&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046480021&partnerID=8YFLogxK

U2 - 10.1161/JAHA.117.008089

DO - 10.1161/JAHA.117.008089

M3 - Article

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VL - 7

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

SN - 2047-9980

IS - 9

M1 - e008089

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