BACKGROUND: We investigated the associations of dietary and lifestyle inflammation scores (DIS and LIS) with the incidence of all cardiovascular disease (CVD) events, its different subtypes, including hard CVD, stroke, myocardial infarction (MI), as well as heart failure (HF). METHODS: We analyzed data from 5866 participants aged ≥ 45 years from the Multi-Ethnic Study of Atherosclerosis (MESA). DIS and LIS were constructed using food frequency and lifestyle questionnaire data. Multivariable Cox regression models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (95% CIs) of DIS and LIS for CVD outcomes. RESULTS: Over 14 years, there were 822, 600, 290, 252, and 270 events of all CVD, hard CVD, HF, stroke, and MI, respectively. In continuous scale, each one-point increase in DIS was associated with higher risk of all CVD (HR: 1.03; 95% CI: 1.01-1.07), hard CVD (1.05; 1.01-1.08), and MI (1.06; 1.01-1.12). In quintile analysis, the highest DIS quintile was associated with an elevated risk of all CVD (1.28; 1.02-1.61; P trend = 0.067) and hard CVD events (1.47; 1.12-1.92; P trend = 0.013). In subgroup analysis, the impact of DIS on all CVD events was more pronounced among overweight participants compared to normal weight or obese counterparts (P-interaction < 0.001). Furthermore, each one-point increase in LIS was associated with a 36% higher risk of HF (1.36; 1.12-1.62). Participants in the highest LIS quintile had a 75% higher risk of HF (1.75: 1.18-2.59), compared to those in the lowest quintile. CONCLUSION: Diet and lifestyle, through their contributions to inflammation, may be associated with higher CVD risk, particularly hard CVD, MI, and HF. TRIAL REGISTRATION: Not applicable.
Ramezankhani et al. (Mon,) studied this question.