Bisher AKIL, MD

Posts Tagged ‘Cardiovascular’

Potatoes are bad food; really?

In General Health on June 15, 2016 at 1:30 am

In 2015, and on the basis of an Institute of Medicine report requested by Congress, the restriction on white potatoes in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), was lifted;   The rationale for removing these limitations on potatoes included their high potassium content and appropriate potassium intake is associated with diminished risk for hypertension,  furthermore , there was insufficient evidence of their health effects. On the international front, the World Health Organization does not include potatoes as vegetables. Although potassium supplementation may be beneficial for chronic disease prevention, in particular prevention of hypertension, a six week feeding trial of 164 pre-hypertensive and hypertensive people found that diets rich in protein or monounsaturated fat reduced blood pressure compared with diets rich in carbohydrates. Because potatoes are high in both glycemic carbohydrates and potassium, their effect on risk of hypertension is unclear.

To assess the relation between potato intake and hypertension, researchers pooled data from three prospective cohort studies,  Nurses’ Health Study (NHS; n=121 700 women, aged 30-55 at the time of cohort inception in 1976), the Nurses’ Health Study II (NHS II; n=116 430 women, aged 25-42 at cohort inception in 1989), and the Health Professionals Follow-up Study (HPFS; n=51 529 men, aged 40-75 at cohort inception in 1986), and adjusted for many potential confounding variables (e.g., age, ethnicity, body-mass index, smoking status, physical activity, medications). A diagnosis of hypertension by a health professional was self reported on the baseline and biennial questionnaires.

Of >187,000 participants without hypertension at baseline, 78,000 participants reported receiving diagnoses of hypertension during follow-up. Participants who consumed ≥1 serving daily of baked, boiled, or mashed potatoes or French fries had excess risk for hypertension compared with those who consumed ≤1 serving monthly (multivariate hazard ratio, 1.12). Similar results were obtained for consumption of baked, boiled, or mashed potatoes alone and consumption of French fries alone (≥4 servings weekly vs. ≤1 serving monthly). However, potato chip consumption alone was not associated with increased risk.

Citation(s):Borgi L et al. Potato intake and incidence of hypertension: Results from three prospective US cohort studies. BMJ 2016 May 17; 353:i2351. (http://dx.doi.org/10.1136/bmj.i2351)

Appeared in NEJM Journal Watch 6/9/2016.
Comments: We generally eat potatoes with salt; could that play a role? However, potatoes chips (lots of salt!) was not associated with increased risk _ There is a lot of explaining to be done_ I am not stopping my potatoes, yet! but I am certainly cutting back_ that’s one person’s opinion_BA

 

Vitamin C & E: do they prevent heart disease?

In Heart on March 17, 2009 at 11:59 pm

Data have suggested possible benefit from antioxidants, especially vitamin C &E in preventing cardiovascular events. However, this benefit has never been confirmed. The Physician’s Health Study II (PHS II) trial was designed to answer this question. The data were presented by Dr. J. Michael Gaziano at the American Heart Association Annual Scientific Sessions, New Orleans, November 2008. The study was placebo controlled, randomized, blinded, parallel and factorial. It screened 273,360 and enrolled: 14,641 male US physicians with mean follow-Up of 8 years and mean age: 64.3 years. Patients were randomized in a 2 x 2 x 2 x 2 factorial trial to either vitamin E (400 IU synthetic α-tocopherol) or placebo every other day, vitamin C (500 mg synthetic ascorbic acid) or placebo daily, multivitamin (Centrum Silver) or placebo, and beta-carotene (50 mg of Lurotin) or placebo every other day. A total of 14,641 healthy males were randomized, 3,656 to active vitamins E and C, 3,659 to active vitamin E and placebo vitamin C, 3,673 to placebo vitamin E and active vitamin C, and 3,653 to placebo vitamins C and E. Baseline characteristics were fairly similar between the four groups. About 61% exercised at least once every week, about 44% were past or current smokers, 77.4% were on aspirin, 42% had a history of hypertension, 36% had a history of hypercholesterolemia, 6% had a history of diabetes, and about 5% had a self-reported history of cardiovascular disease. Compliance was about 72% at 8 years.
Results:
Vitamin E: There was no difference between patients receiving vitamin E or placebo in the incidence of major cardiovascular events (8.5% vs. 8.5%, hazard ratio [HR] 1.01, 95% confidence interval [CI] 0.90-1.13, p = 0.86). There was also no difference in the incidence of myocardial infarction (MI) (3.3% vs. 3.7%, p = 0.22), stroke (3.2% vs. 3.1%, p = 0.45), congestive heart failure (4.0% vs. 4.0%, p = 0.80), or all-cause mortality (11.5% vs. 11.2%, p = 0.15). However, there was a significant increase in the risk of hemorrhagic stroke in the vitamin E arm (0.53% vs. 0.31%, HR 1.74, 95% CI 1.04-2.91, p = 0.04).

Vitamin C: There was no difference between patients receiving vitamin C or placebo in the incidence of major cardiovascular events (8.4% vs. 8.6%, HR 0.99, 95% CI 0.89-1.11, p = 0.91). There was also no difference in the incidence of MI (3.5% vs. 3.4%, p = 0.65), stroke (3.0% vs. 3.4%, p = 0.21), or all-cause mortality (11.7% vs. 11.0%, p = 0.16).

Conclusion:

The results showed  that neither vitamin C nor vitamin E supplementation is associated with a reduction in major cardiovascular outcomes, as compared with placebo, although vitamin E may be associated with a slightly higher incidence of hemorrhagic stroke, compared with placebo.

Comments: No women were enrolled in this study which limits its benefit; questionnaire were used to assess the results. These may make the results a bit weaker, but they are still valid. Next time you decide to buy vitamins, make sure you are buying them for a good reason, otherwise save your money.BA