Mediterranean and DASH Diet Scores and Mortality in Women with Heart Failure: The Women's Health Initiative
Background—Current dietary recommendations for heart failure (HF) patients are largely based on data from non-HF populations; evidence regarding associations of dietary patterns with outcomes in HF is limited. We therefore evaluated associations of Mediterranean and DASH diet scores with mortality among postmenopausal women with HF.
Methods and Results—Women's Health Initiative participants were followed from the date of HF hospitalization through the date of death or last participant contact prior to August 2009. Mediterranean and DASH diet scores were calculated from food-frequency questionnaires. Cox proportional hazards models adjusted for demographics, health behaviors, and health status were used to calculate hazard ratios (HR) and 95% confidence intervals (CI). Over a median of 4.6 years of follow-up, 1,385 of 3,215 (43.1%) participants who experienced a HF hospitalization died. Multivariable-adjusted HRs were 1 (reference), 1.05 (95% CI 0.89-1.24), 0.97 (95% CI 0.81-1.17), and 0.85 (95% CI 0.70-1.02) across quartiles of the Mediterranean diet score (p-trend = 0.08) and 1 (reference), 1.04 (95% CI 0.89-1.21), 0.83 (95% CI 0.70-0.98), and 0.84 (95% CI 0.70-1.00) across quartiles of the DASH diet score (p-trend = 0.01). Diet score components vegetables, nuts, and whole grain intake were inversely associated with mortality.
Conclusions—Higher DASH diet scores were associated with modestly lower mortality in women with HF, and there was a non-significant trend towards an inverse association with Mediterranean diet scores. These data provide support for the concept that dietary recommendations developed for other cardiovascular conditions or general populations may also be appropriate in HF patients.
Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000611.
- Received April 2, 2013.
- Accepted September 25, 2013.