NEW YORK (Reuters Health) - Adhering to a diet that is high in fruits and vegetables and low in animal protein significantly reduces the risk of coronary heart disease and stroke in middle- aged women, according to a report in the Archives of Internal Medicine for April 14.

Prior research has shown that adherence to the Dietary Approaches to Stop Hypertension (DASH) diet can markedly reduce both systolic and diastolic blood pressure in patients with hypertension. The long-term impact of a DASH-style diet on cardiovascular end-points, however, was unclear.

Dr. Teresa T. Fung, from Simmons College in Boston, and colleagues addressed this topic by correlating dietary patterns with cardiovascular outcomes in 88,517 women enrolled in the Nurses' Health Study. The women were between 34 and 59 years of age in 1980 when they began completing food frequency questionnaires.

During 24 years of follow-up, each woman completed seven questionnaires. A score was assigned to each dietary pattern based on how closely it matched a DASH diet.

During follow-up, 2129 nonfatal MIs, 976

heart disease deaths, and 3105 strokes were logged, the report indicates.

After adjusting for known cardiovascular risk factors, increasing adherence to a DASH-style diet significantly reduced the risk of coronary heart disease (p < 0.001 for trend). The relative risk of developing CHD for women in the highest quintile of DASH adherence was 0.76 compared to those in the lowest quintile.

Increasing DASH diet adherence also cut the risk of stroke, with a relative risk of 0.82 for highest vs. lowest quintiles (p = 0.002 for trend).

In a subgroup analysis of women who provided blood samples, the DASH score was inversely related to plasma levels of C-reactive protein (p = 0.008 for trend) and interleukin 6 (p = 0.04 for trend).

"Because a randomized clinical trial of the DASH diet on cardiovascular end points may not be feasible, our study provides, to our knowledge, the strongest evidence to date on the long-term benefits of the DASH diet in the primary prevention of cardiovascular disease among healthy subjects," the authors conclude.

Arch Intern Med 2008;168:713-720.