Mediterranean diet and prevention of cardiovascular disease

A large randomized trial compared three diets in patients at high cardiovascular risk

·        A Mediterranean diet supplemented with olive oil

·        A Mediterranean diet supplemented with mixed nuts

·        Advice to reduce dietary fat 

For the primary composite cardiovascular endpoint of heart attack, paralysis, and sudden death event rates were similar for the Mediterranean diets supplemented with olive oil and mixed nuts, and lower than for the control diet. Although this trial suggests possible substantial cardiovascular benefits from a Mediterranean diet, there was a surprisingly large reduction in events, a low total number of events, and the trial was stopped early for benefit after a median follow-up of 4.8 years.  

A Mediterranean diet is typically high in fruits, vegetables, whole grains, beans, nuts, and seeds and includes olive oil as an important source of fat; there are typically low to moderate amounts of fish, poultry and dairy products, and there is little red meat.

Things you should know about erectile dysfunction

ED is often the result of diseases or conditions that become more common with age or a side effect of the medications used to treat them. Other causes include prostate surgery, stress, relationship problems, and depression. With age tissues also become less elastic and nerve communication slows.

Cardiovascular disease is a common cause. Blocked arteries affect not only the coronary arteries but those throughout the body as well. Up to 30% of men who see their doctors for ED have underlying heart blockages.

Intriguing findings from the Massachusetts Male Aging Study suggest there may be a natural ebb and flow to ED — that is, for some men, trouble with erections may occur, last for a significant amount of time, and then partly or fully disappear without treatment.

For some men, simply losing weight may help. Others may need medications, and there are other options available as well. (Harvard Newsletter)

Aspirin for the primary prevention of cardiovascular disease and cancer

People above the age of 50 without excess bleeding risk should take low-dose daily aspirin (75 to 100 mg) as per the current recommendations.

Patients who are more concerned about the bleeding risks than the potential benefits (prevention of cardiovascular events and cancer) may reasonably choose to not take aspirin for primary prevention.

Meta-analyses of randomized trials have shown aspirin to reduce the risk of non-fatal myocardial infarction (Arch Intern Med 2012; 172:209) and long-term aspirin use reduces overall cancer risk (Lancet 2012; 379:1602).

A meta-analysis addressing this combined outcome suggests that aspirin use in 1000 average risk patients at age 60 years would be expected to result, over a 10-year period, in six fewer deaths, 19 fewer non-fatal myocardial infarctions, 14 fewer cancers, and 16 more major bleeding events.

Aspirin after 50 for the primary prevention of cardiovascular disease and cancer

For people age ≥50 years without excess bleeding risk, the new recommendation is to take a low-dose daily aspirin (75 to 100 mg).

Patients who are more concerned about the bleeding risks than the potential benefits (prevention of cardiovascular events and cancer) may reasonably choose to not take aspirin for primary prevention.

Meta-analyses of randomized trials have shown aspirin to reduce the risk of non-fatal heart attacks and long-term aspirin use reduces overall cancer risk.

A new meta-analysis suggests that aspirin use in 1000 average risk patients at age 60 years would be expected to result, over a 10-year period, in six fewer deaths, 19 fewer non-fatal myocardial infarctions, 14 fewer cancers, and 16 more major bleeding events. (Chest 2012;141:e637S)