Revista Facultad de Medicina de la Universidad Nacional de Colombia
versão impressa ISSN 0120-0011
ANGEL ARANGO, Luis Alberto. Diet and secondary prevention of cardiovascular disease. Rev.fac.med.unal [online]. 2011, vol.59, n.1, pp. 5-18. ISSN 0120-0011.
Background. There is abundant evidence regarding the effects of diet as a strategy for managing cardiovascular risk factors in primary prevention, covering all types of situations and complications including a whole range of studies from cases and controls, retrospective cohorts, prospective studies to controlled random clinical trial. Objectives. Establishing evidence from recent studies and revised and updated clinical practice guidelines about secondary prevention of cardiovascular disease by dietary management. Materials and methods. Databases were electronically searched using the words «secondary prevention» and connectors «heart» and «cardiovascular risk.» Only studies whose main objective had been the reduction of new cardiovascular events were accepted. Results. A Mediterranean-type diet was shown to be associated with lower overall mortality rates, particularly due to cardiac causes. A cholesterol-reducing diet lowered the recurrent heart-attack rate and appearance of angina, as well as recurrent heart-attacks associated with omega 3 fatty acid 18 consumption (recommendations and level of evidence: B-IIa). A fish fat oil rich diet increased the risk of death and sudden death from cardiac causes in subjects suffering from angina and favored the recurrence of ventricular arrhythmias (B-III). Omega-3 fatty acids from fish and vegetables did not reduce greater cardiovascular events in patients with suitable antihypertensive, antithrombotic and dyslipidaemia (BIII) pharmacological therapy. Conclusions. Mediterranean-type diets and those reducing cholesterol rich in omega-3 fatty acids probably have a favourable effect on preventing secondary cardiovascular disease (B-IIa). Such effect disappears when associated with pharmacological treatment of cardiovascular risk factors (B-III). Omega-3 fatty acids probably increase mortality in patients suffering from angina and favour the recurrence of ventricular arrhythmias (B-III).
Palavras-chave : diet; fatty acids; omega-3; risk assessment; cardiovascular diseases; secondary prevention; mortality rate.