Does a Mediterranean diet make statin drugs more effective?

Drugs
statin drugs

A study conducted by researchers in Italy explored the benefits of combining statin drugs with a Mediterranean diet.

Statin drugs are a mainstay treatment for those with a history of cardiovascular-related diseases, such as a heart attack or stroke. Lifestyle modifications, such as a healthy diet, are also recommended in addition to drug therapy to prevent cardiovascular disease. A large body of evidence from observational studies suggests there are beneficial effects of the Mediterranean diet, which is rich in fruit, vegetables, olive oil, fish, legumes, and low in meat and dairy.

Researchers in Italy evaluated the effect of following a Mediterranean diet on the risk of overall and cardiovascular-related death in patients with cardiovascular disease who are also taking statin drugs. Their results were published in the International Journal of Cardiology. The researchers analyzed 1180 subjects with a history of cardiovascular disease. The subjects’ adherence to a Mediterranean diet was evaluated by a Mediterranean diet score and they were followed up for a median of 7.9 years.

Reduced risk of overall and cardiovascular-related death

The study found that following a Mediterranean diet is associated with a reduced risk of overall and cardiovascular-related death, independent of statin drug use. Subjects who had higher adherence to the Mediterranean diet had a 32% lower risk of overall death. A low dose of statin use was only associated with a slightly lower risk of overall death only, and not to cardiovascular-related death risk.

The researchers further analyzed the interaction between the Mediterranean diet and statin drugs. They found that cardiovascular death risk was significantly lower in subjects who used statins and had an average or high adherence to the Mediterranean diet compared to those who did not use statins or had poor adherence to the Mediterranean diet. This suggests a positive interaction between statins and the Mediterranean diet resulting in the risk reduction of cardiovascular disease and death.

The Mediterranean diet may help reduce inflammation

The study also suggests that combining the diet with the medication acts favourably on the inflammation pathway to reduce inflammation, rather than on lipid levels. This is an important finding as high levels of inflammation have been observed to double the risk of death in patients with a history of heart attack or stroke.

The study concludes that the combination of statin drugs and adherence to a traditional Mediterranean diet significantly lowers the risk of cardiovascular death. The real-life study design and long term follow up to strengthen their results, however, they were limited by the self-reporting of diet adherence and the inability to capture inflammatory and lipid levels throughout the whole follow-up period. With proper randomized controlled trials, more conclusive information can be obtained on the relationship between Mediterranean diets and statin drugs on cardiovascular disease and death.

Written by Maggie Leung, PharmD

References:

  1. Bonaccio, M., Castelnuovo, A. D., Costanzo, S., Persichillo, M., Curtis, A. D., Cerletti, C., . . . Iacoviello, L. (2018). Interaction between Mediterranean diet and statins on mortality risk in patients with cardiovascular disease: Findings from the Moli-sani Study. International Journal of Cardiology,276, 248-254. doi:10.1016/j.ijcard.2018.11.117
  2. Bonanni, A. (2018, December 21). Statins are more effective for those who follow the Mediterranean diet. Retrieved January 15, 2019, from https://www.eurekalert.org/pub_releases/2018-12/inmn-sam122118.php

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