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.}",
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    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

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    DO - 10.1161/JAHA.117.008089

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    JO - Journal of the American Heart Association

    JF - Journal of the American Heart Association

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