n a new study on 3.7 million people,
those who reported eating three or more
daily servings of fruits and vegetables
had 18 percent lower odds of PAD than
those reporting eating less.
“Our study provides important information
to the public that something as simple as
adding more fruits and vegetables to your diet
could have a major impact on the prevalence
of life-altering peripheral artery disease,” said
Jeffrey Berger, M.D., associate professor of
medicine and surgery at New York University School
of Medicine in New York City.
PAD is a narrowing of the peripheral arteries to the legs,
stomach, arms and head — most commonly in the legs —
that limits blood flow to the muscles and makes it hard or
painful to walk or stand.
Previous studies linked lower consumption of fruits
and vegetables with the increased occurrence of coronary
heart disease and stroke. But there’s little research on the
association of eating fruits and vegetables and PAD.
In the new study, 6. 3 percent of
participants had PAD and 29. 2 percent
reported eating three or more servings of
fruits and vegetables daily.
Participants completed medical and
lifestyle questionnaires and ankle brachial
index tests at more than 20,000 sites
across America. An ankle brachial index
test is a comparison of blood pressure
differences between readings at the ankle
The study findings also confirmed that Americans’ fruit
and vegetable intake remains dismally low, researchers said.
Low fruit and vegetable intake was particularly associated
with PAD among current and former smokers.
Furthermore, older white women were most likely to eat
three or more servings of fruits and vegetables daily, while
younger black men were the least likely, researchers said.
The research is reported in the American Heart
Association journal Arteriosclerosis, Thrombosis and
Yusuf said. He hopes the results will be incorporated into
updated clinical guidelines for blood pressure management.
Participants experienced very few side effects, which
included muscle pain or weakness, indicating “how safe the
low-dose statin is,” he said.
Laxmi Mehta, M.D., agrees. “It supports that the
intermediate-risk population really should consider statin
usage,” said Mehta, associate professor of medicine at
Ohio State University Wexner Medical Center, who was not
involved in HOPE- 3.
“Certainly, when hypertensive patients are in the office,
I would recommend a risk-stratified approach to determine
benefit and utilization of statin therapy,” she said.
HOPE- 3 also showed a significant statin benefit for a
more ethnically and geographically diverse population than
ever before. Among the participants from 21 countries, half
were Asian and more than a quarter were Hispanic. Only
about 20 percent were white.
For example, Asians were thought to be at higher risk for
side effects of statins than whites, but HOPE- 3 researchers
found that the benefits and safety risks were the same for
both groups, Yusuf said. Previous studies on the benefits and
risks of statins mainly involved high-risk white people.
HOPE- 3’s findings that the use of statins is safe for Asians
and Hispanics, as well as women — who made up nearly
half of participants — support an increased use of statins in
those groups, Mehta said.
The results of HOPE- 3 and other studies provide strong
evidence of significant benefits and low risk of using statins
more widely, especially since generic drugs are available and
affordable in many countries, Yusuf said.
Also, HOPE- 3’s simple approach — no cholesterol
monitoring, no complex screening or blood tests, and
no drug dose adjustments — could reduce costs and
encourage the spread of statins in countries at all economic
levels, he said.
More fruits, vegetables a day may
keep blockages in legs away
By American Heart Association News