Heart Attack

Health Condition

Heart Attack

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

  • High-Fiber Diet

    A high-fiber diet with plenty of fruits, vegetables, beans, oats, and whole grains may protect against heart attacks.
    High-Fiber Diet
    ×

    A high-fiber diet, particularly water-soluble fiber (high in oats, psyllium seeds, fruit, vegetables, and legumes), is associated with decreased risk of both fatal and nonfatal heart attacks,80 probably because these fibers are known to lower cholesterol.81 However, large trials separately studying men and women who were followed for years, have linked the greatest protection to water-insoluble fiber (from cereals),82,83 though scientists have yet to understand why. Until the details are better understood, doctors often recommend increasing intake of fruit, vegetables, beans, oats, and whole grains. In a preliminary study,84 the total number of deaths from cardiovascular disease was found to be significantly lower among men with high fruit consumption.

  • Low-Salt Diet

    Preliminary research has shown that eating too much salt increases the risk for heart disease and death from heart disease in overweight people, further research is needed to confirm these findings.
    Low-Salt Diet
    ×

    Recent preliminary evidence has implicated salt consumption as a risk factor for heart disease and death from heart disease in overweight people.85 Among overweight persons, an increase in salt consumption of 2.3 grams per day was associated with a 44% increase in coronary heart disease mortality, a 61% increase in cardiovascular disease mortality, and a 39% increase in mortality from all causes. Blinded, intervention trials are still needed to confirm these preliminary observations.

  • Coffee

    Drinking five or more cups of coffee per day is associated with an increased risk of nonfatal heart attack in both men and women.
    Coffee
    ×

    Drinking five cups of coffee or more per day has been shown to increase the risk of nonfatal heart attack in both men86 and women.87 Though many studies find such links,88 many others do not.89 Nevertheless, heavy coffee drinking should be avoided. This disparity may result in part from the fact that paper-filtered coffee does not raise cholesterol but percolated, boiled, or French press coffees do. Several recent studies have linked coffee drinking to increased blood levels of homocysteine, another risk factor for heart disease.90,91 In this regard, research has yet to absolve paper-filtered coffee, because these studies have not examined separate effects for coffee prepared by different methods.

  • Eggs

    People with diabetes who eat eggs have higher heart disease risk, so they should limit eggs. People who don’t have diabetes, eating one egg per day is not associated with increased risk.
    Eggs
    ×

    Eating eggs may increase heart attack risk. People who consume eggs have been reported to be more likely to die from all types of heart disease, including heart attack, in some,92 although not all, research.93 Increased oxidation, a state associated with heart attack risk, may be the key. Cooking or exposure to air oxidizes the cholesterol in eggs.94 Eating eggs enhances LDL (“bad”) cholesterol oxidation,95 which may in turn contribute to heart attack risk.

  • Fish

    Several trials report that eating fish decreases heart attack deaths.
    Fish
    ×

    Several trials report that eating fish decreases heart attack deaths96,97 and reduces the size of the infarct,98 though some researchers have not confirmed these findings.99 The link between fish eating and heart attack prevention is supported by research showing that fish oil supplements help reverse atherosclerosis.100

  • Nuts

    Research consistently shows that people who frequently eat nuts have a reduced risk of heart disease, possibly because eating nuts lowers cholesterol.
    Nuts
    ×

    Research consistently shows that people who frequently eat nuts have a dramatically reduced risk of heart disease;101,102 this could be because nut consumption lowers cholesterol levels.103,104 Of nuts commonly consumed, almonds and walnuts may be most effective at lowering cholesterol, and macadamia nuts may be least beneficial.105Hazelnuts106 and pistachio nuts107 may also help lower cholesterol.

    Nuts contain many nutrients that could be responsible for protection against heart disease, including fiber, vitamin E, alpha-linolenic acid (found primarily in walnuts), oleic acid, magnesium, and arginine. Therefore, exactly how nuts lower cholesterol or lower the risk of heart disease remains somewhat unclear. Some doctors even believe that nuts may not be directly protective. Rather, people who eat nuts may not eat as much dairy, eggs, or trans fatty acids from margarine and processed food, the avoidance of which would reduce both cholesterol levels and the risk of heart disease.108,109 Nonetheless, the remarkable consistency of research outcomes strongly suggests that nuts directly protect against heart disease. Although nuts are loaded with calories, a recent preliminary study reported that adding hundreds of calories per day from nuts for six months did not increase body weight in humans110—an outcome supported by several other reports.105 Even when increasing nut consumption has led to weight gain, the amount of added weight has been remarkably less than would be expected given the number of calories added to the diet.106

  • Saturated and Hydrogenated Fats

    Many doctors tell people trying to reduce their risk of heart disease to avoid all meat, margarine, and other processed foods containing hydrogenated oils and dairy fat.
    Saturated and Hydrogenated Fats
    ×

    Dietary fat independently affects heart attack risk. The Nurses’ Health Study found that eating foods high in saturated fats (meat and dairy fat) and trans fatty acids (margarine, hydrogenated vegetable oils, and many processed foods containing hydrogenated vegetable oils) was directly associated with many nonfatal heart attacks and deaths from coronary heart disease.111 Consuming foods high in monounsaturated fat, such as olive oil, and polyunsaturated fat, as found in nuts and most vegetable oils, is linked to a decreased risk. This same study revealed that margarine increased the incidence of heart attack, particularly among women who had eaten margarine consistently for more than a decade.112 Other studies report a direct association between frequent consumption of meat and butter and heart attack occurrence.113

    Many doctors tell people trying to reduce their risk of heart disease to avoid all meat, margarine, and other processed foods containing hydrogenated oils and dairy fat. Fish are often suggested instead of meat; nuts instead of snack foods containing hydrogenated oils; olive oil instead of butter; nonfat yogurt, milk, and even cheese instead of full or reduced fat versions of the same foods; and oatmeal instead of eggs for breakfast.

  • Unsaturated Fats

    Eating foods high in monounsaturated fat, such as olive oil, and polyunsaturated fat, as found in nuts and most vegetable oils, may help protect against heart attack.
    Unsaturated Fats
    ×

    Dietary fat independently affects heart attack risk. The Nurses’ Health Study found that eating foods high in saturated fats (meat and dairy fat) and trans fatty acids (margarine, hydrogenated vegetable oils, and many processed foods containing hydrogenated vegetable oils) was directly associated with many nonfatal heart attacks and deaths from coronary heart disease.114 Consuming foods high in monounsaturated fat, such as olive oil, and polyunsaturated fat, as found in nuts and most vegetable oils, is linked to a decreased risk. This same study revealed that margarine increased the incidence of heart attack, particularly among women who had eaten margarine consistently for more than a decade.115 Other studies report a direct association between frequent consumption of meat and butter and heart attack occurrence.116

    Many doctors tell people trying to reduce their risk of heart disease to avoid all meat, margarine, and other processed foods containing hydrogenated oils and dairy fat. Fish are often suggested instead of meat; nuts instead of snack foods containing hydrogenated oils; olive oil instead of butter; nonfat yogurt, milk, and even cheese instead of full or reduced fat versions of the same foods; and oatmeal instead of eggs for breakfast.

  • Alpha Linolenic Acid

    People who eat diets high in alpha-linolenic acid—found in canola oil and flaxseed products—have high blood levels of omega-3 fatty acids, which may protect against heart attacks.
    Alpha Linolenic Acid
    ×

    People who eat diets high in alpha-linolenic acid (ALA), which is found in canola and flaxseed oils, have higher blood levels of omega-3 fatty acids than those consuming lower amounts,117,118 which may confer some protection against atherosclerosis. In 1994, researchers conducted a study in people with a history of heart disease, using what they called the “Mediterranean” diet.119 The diet was significantly different from what people from Mediterranean countries actually eat, in that it contained little olive oil. Instead, the diet included a special margarine high in ALA. Those people assigned to the Mediterranean diet had a remarkable 70% reduced risk of dying from heart disease compared with the control group during the first 27 months. Similar results were also confirmed after almost four years.120 The diet was high in beans and peas, fish, fruit, vegetables, bread, and cereals; and low in meat, dairy fat, and eggs. Although the authors believe that the high ALA content of the diet was partly responsible for the surprising outcome, other aspects of the diet may have been partially or even totally responsible for decreased death rates. Therefore, the success of the Mediterranean diet does not prove that ALA protects against heart disease.121

  • Complex Carbohydrates

    Eating a diet high in refined carbohydrates (such as white flour, white rice, simple sugars) appears to increase heart attack risk, especially in overweight women.
    Complex Carbohydrates
    ×

    Eating a diet high in refined carbohydrates (e.g., white flour, white rice, simple sugars) appears to increase the risk of coronary heart disease, and thus of heart attacks, especially in overweight women.122

  • Low-Sugar

    Sugar has been associated with reduced HDL (“good”) cholesterol, increased triglycerides, and an increase in other heart attack risk factors.
    Low-Sugar
    ×

    Preliminary research conducted several decades ago suggested that high sugar consumption increased heart attack risk.123 Some researchers at that time disagreed124 and others have subsequently been unable to find a link. Nevertheless, sugar has been associated with reduced HDL (“good”) cholesterol,125 increased triglycerides,126 as well as an increase in other risk factors linked to heart attacks.127 As a result, many doctors recommend that people reduce their intake of sugar despite the fact that high sugar intake leads to only slightly higher risks of heart disease in most reports.128

  • Alcohol Consumption

    Most studies confirm that light to moderate alcohol consumption (one to three drinks per day) significantly reduces heart attack risk compared with heavy or no drinking.
    Alcohol Consumption
    ×

    Most studies confirm that light to moderate alcohol consumption (one to three drinks per day) significantly reduces both fatal and nonfatal heart attack risk129,130,131,132 compared to heavy or no drinking,133,134 though a few reports find the link to protection both weak and statistically insignificant.135 In France, abundant red wine drinking was assumed to be responsible for the country’s remarkably low incidence of heart disease. However, a lower intake of animal fats in the French diet now appears to be the primary reason for what has been called the French paradox.136 However, as animal fat intake continues to increase in France, a trend that began in the 1970s, researchers now speculate that heart disease and heart attacks will also increase.

    Although red wine has been branded best for heart disease in a few reports, all types of alcoholic beverages appear to be beneficial.134 Whether red wine has a clear advantage over other forms of alcohol remains unclear. Alcohol reduces the risk for heart attacks because it increases HDL (“good”) cholesterol138 and acts as a blood thinner.139 High levels of another risk factor for heart attacks, lipoprotein(a), have also been reported to be lowered by drinking alcohol.140

    Despite this healthful effect, alcohol consumption can cause liver disease (e.g., cirrhosis), cancer, high blood pressure, alcoholism, and, at high intake, even an increased risk of heart attack. As a result, some doctors never recommend alcohol, even for people at risk for heart attack. Nevertheless, because limited intake of alcohol lowers heart attack risk, some people at high risk for heart attack who are not alcoholics, have healthy livers and normal blood pressure, and are not at an especially high risk for cancer, may benefit from light drinking. In fact, since heart disease is the leading cause of death in the United States, and alcohol reduces that risk, most studies report that light drinkers live slightly longer on average than teetotalers. In an analysis of 16 trials, men who drank less than two drinks per day and women who averaged less than one drink per day were likely to slightly outlive those who did not drink at all.141 In the same report, however, people who drank beyond these moderate levels in men and low levels in women were more likely to die sooner than were nondrinkers. In deciding whether light drinking might do more good than harm, people at high risk for heart attack should consult a doctor.

  • Eating Healthy

    Making positive dietary changes immediately following a heart attack is likely to decrease the chance of a second heart attack.
    Eating Healthy
    ×

    Making positive dietary changes immediately following a heart attack is likely to decrease the chance of a second heart attack. In one study, individuals began eating more vegetables and fruits, and substituted fish, nuts, and legumes for meat and eggs 24–48 hours after a heart attack. Six weeks later, the diet group had significantly fewer fatal and nonfatal heart attacks than a similar group who did not make these dietary changes.141 This trend continued for an additional six weeks.142

References

1. Davini P, Bigalli A, Lamanna F, Boem A. Controlled study on L-carnitine therapeutic efficacy in post-infarction. Drugs Exp Clin Res 1992;18:355-65.

2. De Pasquale B, Righetti G, Menotti A. L-carnitine for the treatment of acute myocardial infarct. Cardiologia 1990;35:591-6 [in Italian].

3. Iliceto S, Scrutinio D, Bruzzi P, et al. Effects of L-carnitine administration on left ventricular remodeling after acute anterior. J Am Coll Cardiol 1995;26:380-7.

4. Singh RB, Niaz MA, Agarwal P, et al. A randomised double-blind placebo-controlled trial of L-carnitine in suspected acute myocardial infarction. Postgrad Med J 1996;72:45-50.

5. Martina B, Zuber M, Weiss P, et al. Anti-arrhythmia treatment using L-carnitine in acute myocardial infarct. Schweiz Med Wochenschr 1992;122:1352-5 [in German].

6. von Schacky C, Angerer P, Kothny W, et al. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999;130:554-62.

7. Singh RB, Niaz MA, Sharma JP, et al. Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the Indian experiment of infarct survival--4. Cardiovasc Drugs 1997;11:485-91.

8. [No authors listed]. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet 1999;354:447-55.

9. Landmark K, Abdelnoor M, Urdal P, et al. Use of fish oils appears to reduce infarct size as estimated from peak creatine kinase and lactate dehydrogenase activities. Cardiology 1998;89:94-102.

10. Wander RC, Du SH, Ketchum SO, Rowe KE. Alpha-tocopherol influences in vivo indices of lipid peroxidation in postmenopausal women given fish oil. J Nutr 1996;126:643-52.

11. Israelsson B, Brattstrom LE, Hultberg BL. Homocysteine and myocardial infarction. Atherosclerosis 1988;71:227-33.

12. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

13. Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 1999;159:38-44.

14. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

15. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

16. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

17. Nallamothu BK, Fendrick AM, Rubenfire M, et al. Potential clinical and economic effects of homocyst(e)ine lowering. Arch Intern Med 2000;160:3406-12.

18. Landgren F, Israelsson B, Lindgren A, et al. Plasma homocysteine in acute myocardial infarction: homocysteine-lowering effect of folic acid. J Intern Med 1995;237:381-8.

19. Ward M, McNulty H, McPartlin J, et al. Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid. QJM 1997;90:519-24.

20. Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by low-dose folic acid combined with vitamins B6 and B12. Am J Cardiol 1999;83:821-5.

21. Voutilainen S, Lakka TA, Porkkala-Sarataho E, et al. Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:424-8.

22. Singh RB, Rastogi SS, Ghosh S, Niaz MA. Dietary and serum magnesium levels in patients with acute myocardial infarction, coronary artery disease and noncardiac diagnoses. J Am Coll Nutr 1994;13:139-43.

23. Hampton EM, Whang DD, Whang R. Intravenous magnesium therapy in acute myocardial infarction. Ann Pharmacother 1994;28:212-9 [review].

24. [No authors listed]. ISIS-4: a randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58,050 patients with suspected acute myocardial infarction. Lancet 1995;345:669-85.

25. Seelig MS, Elin RJ. Is there a place for magnesium in the treatment of acute myocardial infarction? Am Heart J 1996;132:471-7.

26. Lu Z, Kou W, Du B, et al. Effect of Xuezhikang, an extract from red yeast Chinese rice, on coronary events in a Chinese population with previous myocardial infarction. Am J Cardiol 2008;101:1689-93.

27. Auzepy P, Blondeau M, Richard C, et al. Serum selenium deficiency in myocardial infarction and congestive cardiomyopathy. Acta Cardiol 1987;42:161-6.

28. Oster O, Drexler M, Schenk J, et al. The serum selenium concentration of patients with acute myocardial infarction. Ann Clin Res 1986;18:36-42.

29. Beaglehole R, Jackson R, Watkinson J, et al. Decreased blood selenium and risk of myocardial infarction. Int J Epidemiol 1990;19:918-22.

30. Kardinaal AFM, Kok FJ, Kohlmeier L, et al. Association between toenail selenium and risk of acute myocardial infarction in European men. Am J Epidemiol 1997;145:373-9.

31. Salvini S, Hennekenes CH, Morris JS, et al. Plasma levels of the antioxidant selenium and risk of myocardial infarction among U.S. physicians. Am J Cardiol 1995;76:1218-21.

32. Korpela H, Kumpulainen J, Jussila E, et al. Effect of selenium supplementation after acute myocardial infarction. Res Commun Chem Pathol Pharmacol 1989;65:249-52.

33. Kuklinski B, Weissenbacher E, Fahnrich A. Coenzyme Q10 and antioxidants in acute myocardial infarction. Mol Aspects Med 1994;15 Suppl:s143-7.

34. Singh RB, Niaz MA, Rastogi SS, Tastogi S. Usefulness of antioxidant vitamins in suspected acute myocardial infarction (the Indian experiment of infarct survival-3). Am J Cardiol 1996;77:232-6.

35. Chen LX, Liao JZ, Guo WQ. Effects of Astragalus membranaceus on left ventricular function and oxygen free radical in acute myocardial infarction patients and mechanism of its cardiotonic action. Chung Kuo Chung His I Chieh Ho Tsa Chih 1995;15:141-3 [in Chinese].

36. Shi HM, Dai RH, Wang SY. Primary research on the clinical significance of ventricular late potentials (VLPs), and the impact of mexiletine, lidocaine and Astragalus membranaceus on VLPs. Chung His I Chieh Ho Tsa Chih 1991;11:259, 265-7 [in Chinese].

37. Singh RB, Niaz MA, Sharma JP, et al. Plasma levels of antioxidant vitamins and oxidative stress in patients with acute myocardial infarction. Acta Cardiol 1994;49:441-52.

38. Levy Y, Bartha P, Ben-Amotz A, et al. Plasma antioxidants and lipid peroxidation in acute myocardial infarction and thrombolysis. J Am Coll Nutr 1998;17:337-41.

39. Singh RB, Niaz MA, Rastogi SS, Tastogi S. Usefulness of antioxidant vitamins in suspected acute myocardial infarction (the Indian experiment of infarct survival-3). Am J Cardiol 1996;77:232-6.

40. Kardinaal AFM, Kok FJ, Ringstad J, et al. Antioxidants in adipose tissue and risk of myocardial infarction: the EURAMIC study. Lancet 1993;342:1379-84.

41. Tavani A, Negri E, D'Avanzo B, La Vecchia C. Beta-carotene intake and risk of nonfatal acute myocardial infarction in women. Eur J Epidemiol 1997;13:631-7.

42. Rapola JM, Virtamo J, Ripatti S, et al. Randomised trial of alpha-tocopherol and beta-carotene supplements on incidence of major coronary events in men with previous myocardial infraction. Lancet 1997;349:1715-20.

43. Virtamo J, Rapola JM, Ripatti S, et al. Effect of vitamin E and beta carotene on the incidence of primary nonfatal myocardial infarction and fatal coronary heart disease. Arch Intern Med 1998;158:668-75.

44. Klipstein-Grobusch K, Geleijnse JM, den Breeijen JH, et al. Dietary antioxidants and risk of myocardial infarction in the elderly: the Rotterdam Study. Am J Clin Nutr 1999;69:261-6.

45. Marx A, Neutra RR. Magnesium in drinking water and ischemic heart disease. Epidemiol Rev 1997;19:258-72.

46. Rubenowitz E, Molin I, Axelsson G, Rylander R. Magnesium in drinking water in relation to morbidity and mortality from acute myocardial infarction. Epidemiology 2000;11:416-21.

47. Galloe AM, Rasmussen HS, Jorgensen LN, et al. Influence of oral magnesium supplementation on cardiac events among survivors of an acute myocardial infarction. BMJ 1993;307:585-7.

48. Singh RB, Singh NK, Niaz MA, Sharma JP. Effect of treatment with magnesium and potassium on mortality and reinfarction of patients with suspected acute myocardial infarction. Int J Clin Pharmacol Ther 1996;34:219-25.

49. Singh RB. Effect of dietary magnesium supplementation in the prevention of coronary heart disease and sudden cardiac death. Magnesium Trace Elem 1990;9:143-51.

50. Israelsson B, Brattstrom LE, Hultberg BL. Homocysteine and myocardial infarction. Atherosclerosis 1988;71:227-33.

51. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

52. Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 1999;159:38-44.

53. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

54. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

55. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

56. Nallamothu BK, Fendrick AM, Rubenfire M, et al. Potential clinical and economic effects of homocyst(e)ine lowering. Arch Intern Med 2000;160:3406-12.

57. Landgren F, Israelsson B, Lindgren A, et al. Plasma homocysteine in acute myocardial infarction: homocysteine-lowering effect of folic acid. J Intern Med 1995;237:381-8.

58. Ward M, McNulty H, McPartlin J, et al. Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid. QJM 1997;90:519-24.

59. Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by low-dose folic acid combined with vitamins B6 and B12. Am J Cardiol 1999;83:821-5.

60. Voutilainen S, Lakka TA, Porkkala-Sarataho E, et al. Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:424-8.

61. Israelsson B, Brattstrom LE, Hultberg BL. Homocysteine and myocardial infarction. Atherosclerosis 1988;71:227-33.

62. Ridker PM, Manson JE, Buring JE, et al. Homocysteine and risk of cardiovascular disease among postmenopausal women. JAMA 1999;281:1817-21.

63. Bots ML, Launer LJ, Lindemans J, et al. Homocysteine and short-term risk of myocardial infarction and stroke in the elderly: the Rotterdam Study. Arch Intern Med 1999;159:38-44.

64. Stampfer MJ, Malinow R, Willett WC, et al. A prospective study of plasma homocyst(e)ine and risk of myocardial infarction in US physicians. JAMA 1992;268:877-81.

65. Folsom AR, Nieto FJ, McGovern PG, et al. Prospective study of coronary heart disease incidence in relation to fasting total homocysteine, related genetic polymorphisms, and B vitamins. Circulation 1998;98:204-10.

66. Kuller LH, Evans RW. Homocysteine, vitamins, and cardiovascular disease. Circulation 1998;98:196-9 [editorial/review].

67. Nallamothu BK, Fendrick AM, Rubenfire M, et al. Potential clinical and economic effects of homocyst(e)ine lowering. Arch Intern Med 2000;160:3406-12.

68. Landgren F, Israelsson B, Lindgren A, et al. Plasma homocysteine in acute myocardial infarction: homocysteine-lowering effect of folic acid. J Intern Med 1995;237:381-8.

69. Ward M, McNulty H, McPartlin J, et al. Plasma homocysteine, a risk factor for cardiovascular disease, is lowered by physiological doses of folic acid. QJM 1997;90:519-24.

70. Lobo A, Naso A, Arheart K, et al. Reduction of homocysteine levels in coronary artery disease by low-dose folic acid combined with vitamins B6 and B12. Am J Cardiol 1999;83:821-5.

71. Voutilainen S, Lakka TA, Porkkala-Sarataho E, et al. Low serum folate concentrations are associated with an excess incidence of acute coronary events: the Kuopio Ischaemic Heart Disease Risk Factor Study. Eur J Clin Nutr 2000;54:424-8.

72. Chambers JC, McGregor A, Jean-Marie J, et al. Demonstration of rapid onset vascular endothelial dysfunction after hyperhomocysteinemia. An effect reversible with vitamin C therapy. Circulation 1999;99:1156-60.

73. Fuller CJ, Grundy SM, Norkus EP, Jialal I. Effect of ascorbate supplementation on low density lipoprotein oxidation in smokers. Atherosclerosis 1996;119:139-50.

74. Rath M, Pauling L. Solution to the puzzle of human cardiovascular disease: Its primary cause is ascorbate deficiency leading to the deposition of lipoprotein (a) and fibrinogen/fibrin in the vascular wall. J Orthomol Med 1992;6:125-34.

75. Manson JE, Stampfer MJ, Willett WC, et al. A prospective study of vitamin C and incidence of coronary heart disease in women. Circulation 1992;85:865 [abstract].

76. Klipstein-Grobusch K, Geleijnse JM, den Breeijen JH, et al. Dietary antioxidants and risk of myocardial infarction in the elderly: the Rotterdam Study. Am J Clin Nutr 1999;69:261-6.

77. Nyyssönen K, Parvianinen MT, Salonen R, et al. Vitamin C deficiency and risk of myocardial infarction: prospective population study of men from eastern Finland. BMJ 1997;314:634-8.

78. Simon JA, Hudes ES, Browner WS. Serum ascorbic acid and cardiovascular disease prevalence in U.S. adults. Epidemiology 1998;9:316-21.

79. Rimm EB, Stampfer MJ, Ascherio A, et al. Vitamin E consumption and the risk of coronary heart disease in men. N Engl J Med 1993;328:1450-6.

80. Pietinen P, Rimm EB, Korhonen P, et al. Intake of dietary fiber and risk of coronary heart disease in a cohort of Finnish men. The Alpha-Tocopherol, Beta-Carotene Prevention Study. Circulation 1996;94:2720-7.

81. Brown L, Rosner B, Willett WW, Sacks FM. Cholesterol-lowering effects of dietary fiber: a meta-analysis. Am J Clin Nutr 1999;69:30-42.

82. Rimm EB, Ascherio A, Giovannucci E, et al. Vegetable, fruit, and cereal fiber intake and risk of coronary heart disease among men. JAMA 1996;275:447-51.

83. Wolk A, Manson JE, Stampfer MJ, et al. Long-term intake of dietary fiber and decreased risk of coronary heart disease among women. JAMA 1999;281:1998-2004.

84. Strandhagen E, Hansson PO, Bosaeus I, et al. High fruit intake may reduce mortality among middle-aged and elderly men. The Study of Men Born in 1913. Eur J Clin Nutr 2000;54:337-41.

85. He J, Ogden LG, Vupputuri S, et al. Dietary sodium intake and subsequent risk of cardiovascular disease in overweight adults. JAMA 1999;282:2027-34.

86. Rosenberg L, Palmer JR, Kelly JP, et al. Coffee drinking and nonfatal myocardial infarction in men under 55 years of age. Am J Epidemiol 1988;128:570-8.

87. Palmer JR, Rosenberg L, Rao RS, Shapiro S. Coffee consumption and myocardial infarction in women. Am J Epidemiol 1995;141:724-31.

88. Greenland S. A meta-analysis of coffee, myocardial infarction, and coronary death. Epidemiology 1993;4:366-74.

89. Myers MG, Basinski A. Coffee and coronary heart disease. Arch Intern Med 1992;152:1767-2.

90. Stolzen berg-Solomon RZ, Miller ER III, Maguire MG, et al. Association of dietary protein intake and coffee consumption with serum homocysteine concentrations in an older population. Am J Clin Nutr 1999;69:467-75.

91. Nygård O, Refsum H, Velanb PM, et al. Coffee consumption and plasma total homocysteine: The Hordaland Homocysteine Study. Am J Clin Nutr 1997;65:136-43.

92. Shekelle RB, Stamler J. Dietary cholesterol and ischaemic heart disease. Lancet 1989;1:1177-9.

93. Hu FB, Stampfer MJ, Rimm EB, et al. A prospective study of egg consumption and risk of cardiovascular disease in men and women. JAMA 1999;281:1387-94.

94. Raloff J. Oxidized lipids: a key to heart disease? Sci News 1985;127:278.

95. Levy Y, Maor I, Presser D, Aviram M. Consumption of eggs with meals increases the susceptibility of human plasma and low-density lipoprotein to lipid peroxidation. Ann Nutr Metabol 1996;40:243-51.

96. Daviglus ML, Stamler J, Orencia AJ, et al. Fish consumption and the 30-year risk of fatal myocardial infarction. N Engl J Med 1997;336:1046-53.

97. Burr ML, Fehily AM, Gilbert JF, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989;ii:757-61.

98. Landmark K, Abdelnoor M, Kilhovd B, Dorum HP. Eating fish may reduce infarct size and the occurrence of Q wave infarcts. Eur J Clin Nutr 1998;52:40-4.

99. Morris MC, Manson JE, Rosner B, et al. Fish consumption and cardiovascular disease in the physicians' health study: a prospective study. Am J Epidemiol 1995;142:166-75.

100. von Schacky C, Angerer P, Kothny W, et al. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999;130:554-62.

101. Hu FB, Stampfer MJ, Manson JE, et al. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ 1998;317:1341-5.

102. Fraser GE, Sabaté J, Beeson WL, Strahan TM. A possible protective effect of nut consumption on risk of coronary heart disease. Arch Intern Med 1992;152:1416-24.

103. Abbey M, Noakes M, Belling GB, Nestel PJ. Partial replacement of saturated fatty acids with almonds or walnuts lowers total plasma cholesterol and low-density-lipoprotein cholesterol. Am J Clin Nutr 1994;59:995-9.

104. Sabaté J, Frasser GE, Burke K, et al. Effects of walnuts on serum lipid levels and blood pressure in normal men. N Engl J Med 1993;328:603-7.

105. Fraser GE. Nut consumption, lipids, and risk of a coronary event. Clin Cardiol 1999;22(7 Suppl):III11-5 [review].

106. Durak I, Köksal I, Kaçmaz M, et al. Hazelnut supplementation enhances plasma antioxidant potential and lowers plasma cholesterol levels. Clin Chim Actia 1999;284:113-5 [letter].

107. Edwards K, Kwaw I, Matud J, Kurtz I. Effect of pistachio nuts on serum lipid levels in patients with moderate hypercholesterolemia. J Am Coll Nutr 1999;18:229-32.

108. Mirkin G. Walnuts and serum lipids. N Engl J Med 1993;329:358 [letter].

109. Mann GV. Walnuts and serum lipids. N Engl J Med 1993;329:358 [letter].

110. Fraser GE, Jaceldo K, Sabaté J, et al. Changes in body weight with a daily supplement of 340 calories from almonds for six months. FASEB J 1999;13:A539 [abstract].

111. Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337:1491-9.

112. Willett WC, Stampfer MJ, Manson JE, et al. Intake of trans fatty acids and risk of coronary heart disease among women. Lancet 1993;341:581-5.

113. Gramenzi A, Gentile A, Fasoli M, et al. Association between certain foods and risk of acute myocardial infarction in women. BMJ 1990;300:771-3.

114. Hu FB, Stampfer MJ, Manson JE, et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997;337:1491-9.

115. Willett WC, Stampfer MJ, Manson JE, et al. Intake of trans fatty acids and risk of coronary heart disease among women. Lancet 1993;341:581-5.

116. Gramenzi A, Gentile A, Fasoli M, et al. Association between certain foods and risk of acute myocardial infarction in women. BMJ 1990;300:771-3.

117. Gramenzi A, Gentile A, Fasoli M, et al. Association between certain foods and risk of acute myocardial infarction in women. BMJ 1990;300:771-3.

118. Hu FB, Stampfer MJ, Manson JE, et al. Frequent nut consumption and risk of coronary heart disease in women: prospective cohort study. BMJ 1998;317:1341-5.

119. de Lorgeril M, Renaud S, Mamelle N, et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary heart disease. Lancet 1994;343:1454-9.

120. de Lorgeril M, Salen P, Martin JL, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999;99:779-85.

121. Rice RD. Mediterranean diet. Lancet 1994;344:893-4 [letter].

122. Liu S, Willett WC, Stampfer MJ, et al. A prospective study of dietary glycemic load, carbohydrate intake, and risk of coronary heart disease in US women. Am J Clin Nutr 2000;71:1455-61.

123. Yudkin J, Morland J. Sugar intake and myocardial infarction. Am J Clin Nutr 1967;20:503-6.

124. Platt L, Ball KP, Brigden WW, et al. Dietary sugar intake in men with myocardial infarction. Lancet 1970 Dec 19;2:1265-71.

125. Yudkin J, Kang SS, Bruckdorfer KR. Effects of high dietary sugar. Br Med J 1980;281:1396.

126. Albrink MJ, Ullrich IH. Interaction of dietary sucrose and fiber on serum lipids in healthy young men fed high carbohydrate diets. Am J Clin Nutr 1986;43:419-28.

127. Reiser S. Effect of dietary sugars on metabolic risk factors associated with heart disease. Nutr Health 1985;3:203-16.

128. Liu K, Stamler J, Trevisan M, Moss D. Dietary lipids, sugar, fiber, and mortality from coronary heart disease. Bivariate analysis of international data. Arteriosclerosis 1982;2:221-7.

129. Rosenberg L, Slone D, Shapiro S, et al. Alcoholic beverages and myocardial infarction in young women. Am J Public Health 1981;71:82-5.

130. Kono S, Handa K, Kawano T, et al. Alcohol intake and nonfatal acute myocardial infarction in Japan. Am J Cardiol 1991;68:1011-4.

131. Jackson R, Scragg R, Beaglehole R. Does recent alcohol consumption reduce the risk of acute myocardial infarction and coronary death in regular drinkers? Am J Epidemiol 1992;136:819-24.

132. Hammar N, Romelsjo A, Alfredsson L. Alcohol consumption, drinking pattern and acute myocardial infarction. A case referent study based on the Swedish Twin Register. J Intern Med 1997;241:125-31.

133. Bianchi C, Negri E, La Vecchia C, Franceschi S. Alcohol consumption and the risk of acute myocardial infarction in women. J Epidemiol Community Health 1993;47:308-11.

134. Gaziano JM, Hennekens CH, Godfried SL, et al. Type of alcoholic beverage and risk of myocardial infarction. Am J Cardiol 1999;83:52-7.

135. Hart CL, Smith GD, Hole DJ, Hawthorne VM. Alcohol consumption and mortality from all causes, coronary heart disease, and stroke: results from a prospective cohort study of Scottish men with 21 years of follow up. BMJ 1999;318:1725-9.

136. Law M, Wald N. Why heart disease mortality is low in France: the time lag explanation. BMJ 1999;318:1471-80 [review].

137. Gaziano JM, Buring JE, Breslow JL, et al. Moderate alcohol intake, increased levels of high-density lipoprotein and its subfractions, and decreased risk of myocardial infarction. N Engl J Med 1993;329:1829-34.

138. Renaud S, de Lorgeril M. Wine, alcohol, platelets and the French paradox for coronary heart disease. Lancet 1992;339:1523-6.

139. Sharpe PC, McGrath LT, McClean E, et al. Effect of red wine consumption on lipoprotein (a) and other risk factors for atherosclerosis. Q J Med 1995;88:101-8.

140. Holman CDJ, English DR, Milne E, Winter MG. Meta-analysis of alcohol and all-cause mortality: a validation of NHMRC recommendations. Med J Aust 1996;64:141-5.

141. Singh RB, Rastogi SS, Verma R, et al. An Indian experiment with nutritional modulation in acute myocardial infarction. Am J Cardiol 1992;69:879-85.

142. Singh RB, Niaz MA, Ghosh S, et al. Effect on mortality and reinfarction of adding fruits and vegetables to a prudent diet in the Indian Experiment of Infarct Survival (IEIS). J Am Coll Nutr 1993;12:255-61.

143. Prescott E, Hippe M, Schnohr P, et al. Smoking and risk of myocardial infarction in women and men: longitudinal population study. BMJ 1998;316:1043-7.

144. Nyboe J, Jensen G, Appleyard M, Schnohr P. Smoking and the risk of first acute myocardial infarction. Am Heart J 1991;122:438.

145. Rosenberg L, Palmer JR, Shapiro S. Decline in the risk of myocardial infarction among women who stop smoking. N Engl J Med 1990;322:213-7.

146. Zhu B, Sun Y, Sievers RE, et al. Exposure to environmental tobacco smoke increases myocardial infarct size in rats. Circulation 1994;89:1282-90.

147. Zhu B, Parmley WW. Hemodynamic and vascular effects of active and passive smoking. Am Heart J 1995;130:1270-5 [review].

148. Wilson K, Gibson N, Willan A, Cook D. Effect of smoking cessation on mortality after myocardial infarction: meta-analysis of cohort studies. Arch Intern Med 2000;160:939-44 [review].

149. Mittleman MA, Maclure M, Tofler GH, et al. Triggering of acute myocardial infarction by heavy physical exertion. Protection against triggering by regular exertion. Determinants of Myocardial Infarction Onset Study Investigators. N Engl J Med 1993;329:1677-83.

150. Willich SN, Lewis M, Lowel H, et al. Physical exertion as a trigger of acute myocardial infarction. Triggers and Mechanisms of Myocardial Infarction Study Group. N Engl J Med 1993;329:1684-90.

151. Mittleman MA, Siscovick DS. Physical exertion as a trigger of myocardial infarction and sudden cardiac death. Cardiol Clin 1996;14:263-70 [review].

152. Muller JE, Mittleman A, Maclure M, et al. Triggering myocardial infarction by sexual activity. Low absolute risk and prevention by regular physical exertion. Determinants of Myocardial Infarction Onset Study Investigators. JAMA 1996;275:1405-9.

153. Schargrodsky H, Rozlosnik J, Ciruzzi M, et al. Body weight and nonfatal myocardial infarction in a case-control study from Argentina. Soz Praventivmed 1994;39:126-33.

154. Tavani A, Negri E, D'Avanzo B, La Vecchia C. Body weight and risk of nonfatal acute myocardial infarction among women: a case-control study from northern Italy. Prev Med 1997;26:550-5.

155. Kawachi I, Sparrow D, Kubzansky LD, et al. Prospective study of a self-report type A scale and risk of coronary heart disease: test of the MMPI-2 type A scale. Circulation 1998;98:405-12.

156. Raymond C. Distrust, rage may be ‘toxic core' that puts ‘type A' person at risk. JAMA 1989;261:813.

157. Dimsdale JE. A perspective on type A behavior and coronary disease. N Engl J Med 1988;318:110-2 [editorial].

158. Friedman M, Thoresen CE, Gill JJ, et al. Alteration of type A behavior and reduction in cardiac recurrences in postmyocardial infarction patients. Am Heart J 1984;108:237-48.

159. Kawachi I, Sparrow D, Spiro A 3rd, et al. A prospective study of anger and coronary heart disease. The Normative Aging Study. Circulation 1996;94:2090-5.

160. Kubzansky LD, Kawachi I, Spiro A 3rd, et al. Is worrying bad for your heart? A prospective study of worry and coronary heart disease in the Normative Aging Study. Circulation 1997;95:818-24.

161. Hammar N, Alfredsson L, Johnson JV. Job strain, social support at work, and incidence of myocardial infarction. Occup Environ Med 1998;55:548-53.

162. Knox SS, Adelman A, Ellison RC, et al. Hostility, social support, and carotid artery atherosclerosis in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Cardiol 2000;86:1086-9.

163. Knox SS, Siegmund KD, Weidner G, et al. Hostility, social support, and coronary heart disease in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Cardiol 1998;82:1192-6.

164. Orth-Gomer K, Wamala SP, Horsten M, et al. Marital stress worsens prognosis in women with coronary heart disease: the Stockholm female coronary risk study. JAMA 2000;284:3008-14.

165. Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet 1999;354:1229-33 [review].

Copyright © 2024 TraceGains, Inc. All rights reserved.

Learn more about TraceGains, the company.

The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.

Log In

You need to log into the site to use this feature

Create A Free Account To Use Medicine Chest

This feature requires registration. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier.

Benefits Include:

Store & manage your medication list
Medication pricing updates
Import medication from your pharmacy
Medication information
Pill & refill reminders
Medication journal & mood log

Sign up to use Medicine Chest

Create A Free Account To Use this feature

This feature requires registration. Sign up or log in to your free WellRx account to gain access to this and other tools to help make managing your medications and wellness easier.

Benefits Include:

Store & manage your medication list
Medication pricing updates
Import medication from your pharmacy
Medication information
Pill & refill reminders
Medication journal & mood log

Sign up to use this feature

You will be redirected to your program in 5 seconds.

Hi there.

Our Terms and Conditions and Privacy Policy have recently been updated.

Learn More


I Accept

By declining you will be logged out of your account

;