The association of Mediterranean diet with lower risk of acute coronary syndromes in hypertensive subjects

Background: The elevation of blood pressure levels has been recognised as a determinant of the risk for several common cardiovascular diseases. In this work we examined the effect of Mediterranean type of diet on coronary risk in subjects with hypertension. Methods: CARDIO2000 consisted of 848 randomly selected hospitalised patients (695 males, 58±10 years old; 153 females, 65±9 years old) for first event of coronary heart disease (CHD) and 1078 paired, by sex–age, hospitalised controls without CHD. The adoption of the Mediterranean diet was assessed through a validated questionnaire developed by the National School of Public Health. Results: 418 (49%) of the patients and 303 (28%) of the controls were hypertensive. Of them 21 (5%) patients and 36 (12%) controls were unaware of their condition, 94 (22%) and 34 (11%) were untreated, 148 (35%) and 111 (36%) were uncontrolled and 155 (38%) and 122 (41%) were controlled (P<0.01). One hundred and sixty-two (19%) of the patients and 265 (25%) of the controls (P<0.01) adopted the Mediterranean type of diet. Our results suggest that the adoption of Mediterranean diet reduces the risk of developing acute coronary syndromes by 17% (odds RATIO=0.83, 95% CI 0.73–0.88, P<0.01) in controlled hypertensive subjects, by 8% (odds RATIO=0.92, 95% CI 0.87–0.95, P<0.05) in unaware, by 7% (odds RATIO=0.93, 95% CI 0.88–0.95, P<0.05) in acknowledged but uncontrolled and by 20% (odds RATIO=0.80, 95% CI 0.71–0.89, P<0.01) in normotensive subjects. Conclusion: According to our findings the adoption of the Mediterranean diet is associated with the reduction of coronary risk in hypertensive subjects.