Related Experiment Video
Updated: Oct 17, 2025
Fundus Photography as a Convenient Tool to Study Microvascular Responses to Cardiovascular Disease Risk Factors in Epidemiological Studies
Published on: October 22, 2014
Influence of dietary intervention on microvascular endothelial function in coronary patients and atherothrombotic
Marta Millan-Orge1, Jose D Torres-Peña1,2,3,4, Antonio Arenas-Larriva1,2,3,4
1Lipids and Atherosclerosis Unit, Internal Medicine Unit, Reina Sofia University Hospital, 14004, Cordoba, Spain.
Insights
Healthy diets improve long-term microvascular function in coronary heart disease (CHD) patients. This enhancement was observed across all risk groups, with greater improvements in reactive vasodilation noted in lower-risk individuals.
Area of Science:
- Cardiovascular Medicine
- Nutritional Science
- Vascular Biology
Background:
- Endothelial dysfunction is central to atherosclerosis development.
- Long-term effects of healthy diets on microvascular function in coronary heart disease (CHD) patients remain understudied.
- The impact of dietary interventions on CHD recurrence risk and microvascular function needs further investigation.
Purpose of the Study:
- To assess the long-term impact of dietary interventions on microvascular endothelial function in CHD patients.
- To determine if improvements in microvascular function correlate with reduced risk of CHD recurrence.
- To compare the effects of the Mediterranean diet versus a low-fat diet on microvascular function and recurrence risk.
Main Methods:
- The CORDIOPREV study, a randomized controlled trial, involved 1,002 CHD patients.
- Participants were assigned to either a Mediterranean diet or a low-fat diet for 6 years.
- Microvascular endothelial function was assessed using laser-doppler flowmetry at baseline and after 6 years, evaluating basal flow and reactive hyperemia. CHD recurrence risk was determined using the TRS2P score.
Main Results:
- A significant long-term improvement in both basal flow and reactive hyperemia was observed in the overall cohort following dietary intervention (p < 0.001).
- No significant differences in microvascular function improvements were found between the Mediterranean and low-fat diet groups.
- While basal flow increased similarly across all risk groups, reactive hyperemia area showed greater improvement in the low-risk group compared to moderate and high-risk groups.
Conclusions:
- Healthy dietary patterns can lead to sustained long-term improvements in microvascular endothelial function in patients with coronary heart disease.
- The degree of improvement in reactive vasodilation to ischemia is influenced by the patient's risk of CHD recurrence.
- Dietary interventions show potential for managing vascular health in CHD patients, though specific diet type did not yield differential effects in this study.
Abstract:
Endothelial dysfunction is a key player in both the onset and development of atherosclerosis. No study has examined whether healthy dietary patterns can improve microvascular endothelial function in patients with coronary heart disease (CHD) in the long-term and whether this relationship can affect patient's risk of CHD recurrence. In the CORDIOPREV study, a randomized, double-blind, controlled trial, dietary intervention with either the Mediterranean diet or a low-fat diet was implemented in 1,002 CHD patients. A laser-doppler flowmetry was performed at baseline and after 6 years of follow up in 664 patients, evaluating the effects of this dietary intervention on microvascular basal flow and reactive hyperaemia area, as well as on the risk of CHD recurrence, based on the TRS2P risk score. Basal flow (97.78 ± 2.79 vs. 179.31 ± 5.06 arbitrary perfusion units, 83.38% increase, p < 0.001) and reactive hyperaemia area (4233.3 ± 127.73 vs. 9695.9 ± 205.23 arbitrary perfusion units per time, 129.04% increase, p < 0.001) improved after the dietary intervention in the cohort, without finding differences due to the diet (p > 0.05 for the diet-effect). When patients were stratified to low, moderate or high-risk of recurrence, basal flow was similarly increased in all three groups. However, reactive hyperaemia area was improved to a greater extent in patients at the low-risk group compared with those at moderate or high-risk. No differences were observed between diets. Healthy dietary patterns can improve microvascular endothelial function and this improvement persists in the long-term. Patients with a low-risk of CHD recurrence show a greater improvement in reactive vasodilation to ischemia than patients in the moderate or high-risk groups.
Related Concept Videos
01:26Atherosclerosis III: Management
01:26Coronary Artery Disease IV: Preventive Measures
01:30Coronary Artery Disease I: Introduction
01:27Coronary Artery Disease V: Interprofessional Care
01:23Atherosclerosis IV: Nursing Management
01:26Coronary Artery Disease II: Pathophysiology