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Are Lipid-Lowering and Antihypertensive Medications Used as Complements to Heart-Healthy Diets? A Scoping Review
Clémence Desjardins1, Marie Cyrenne-Dussault1, Olivier Barbier2
1Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Québec City, Canada; Faculty of Pharmacy, Laval University, Québec City, Canada.
Insights
This review found limited evidence on how heart-healthy diets and cardiovascular disease (CVD) medications interact. More prospective studies are needed to understand if medications complement diet for CVD prevention.
Area of Science:
- Cardiovascular Disease Prevention
- Nutritional Science
- Pharmacology
Background:
- Cardiovascular disease (CVD) prevention strategies often involve both heart-healthy diets and medications like antihypertensives and lipid-lowering drugs.
- The interplay between dietary choices and medication use in CVD prevention remains incompletely understood.
- Assessing whether medications complement dietary interventions is crucial for optimizing CVD risk reduction.
Purpose of the Study:
- To conduct a scoping review of observational studies examining the relationship between diet and antihypertensive/lipid-lowering medication use.
- To evaluate the extent to which medication use complements heart-healthy dietary intakes in CVD prevention.
- To identify gaps in the literature regarding the dynamics between diet and medication in CVD prevention.
Main Methods:
- Searched major databases (MEDLINE, Embase, Web of Science, CINAHL) up to January 14, 2023.
- Included studies assessing intraindividual dietary changes with medication initiation/use or interindividual dietary differences between users and nonusers.
- Analyzed 17 selected studies, noting their designs (prospective, cross-sectional) and geographical origin.
Main Results:
- Only 3 of 17 studies prospectively assessed intraindividual dietary changes related to medication use, with no data on pre-initiation diet.
- Most studies (14/17) used cross-sectional designs, limiting the understanding of temporal dynamics between diet and medication.
- Evidence from 8 studies suggested medication complemented heart-healthy diets (primarily in Europe), while 9 studies (primarily in the US) found no such evidence, indicating potential geographical differences.
- No studies explored the long-term impact of diet-medication dynamics on CVD risk.
Conclusions:
- The current literature offers an incomplete view of how antihypertensive and lipid-lowering medications interact with diet in CVD prevention.
- There is a need for prospective studies that track intraindividual dietary changes alongside medication initiation and use.
- Future research should investigate how these combined interventions influence long-term cardiovascular risk.
Abstract:
In cardiovascular disease (CVD) prevention, whether antihypertensive and lipid-lowering medications are used as complements to heart-healthy diets has not been thoroughly assessed. This scoping review aimed to 1) analyze observational studies that assessed the relationship between diet and antihypertensive/lipid-lowering medication use and 2) evaluate whether medication was used as a complement to heart-healthy dietary intakes. We searched MEDLINE, Embase, Web of Science, and CINAHL through 14 January, 2023, for studies that assessed either 1) intraindividual changes in diet associated with lipid-lowering/antihypertensive medication initiation or use or 2) interindividual differences in diet between users and nonusers of these medications. A total of 17 studies were included. Of those, 3 prospectively assessed the intraindividual changes in diet associated with medication initiation or use, but none documented potential changes in diet prior to medication initiation. The 14 other studies compared dietary intakes of medication users and nonusers, most of which also relied on an incomplete assessment of the temporal dynamics between diet and medication use as they employed cross-sectional (n = 12) or repeated cross-sectional (n = 2) designs. Data from 8 studies, including 4 of the 5 studies from Europe, suggested that medication was used as a complement to heart-healthy diets, whereas data from the 9 other studies, including the 4 conducted in the United States, provided no such evidence, indicating potential between-country differences in this relationship. Finally, no studies investigated how the dynamics between diet and medication use influenced the long-term CVD risk. This scoping review suggests that the current literature on the relationship between lipid-lowering/antihypertensive medication use and diet provides an incomplete perspective on how medication may influence diet in CVD prevention. Prospective studies assessing intraindividual changes in diet associated with medication initiation and use and how these dynamics influence the CVD risk are thus needed.
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