TABLE 3.
Risk of cardiovascular disease outcomes according to tertile and continuous dietary guideline adherence indices1
| Tertile of dietary guideline adherence indices | ||||||
|---|---|---|---|---|---|---|
| Index | Tertile 1 | Tertile 2 | Tertile 3 | P-trend2 | Continuous (per 10 points) | P-difference3 |
| Cardiovascular disease4 | ||||||
| HEI-1990 | 1 [Ref] | 0.83 (0.68, 1.03) | 0.76 (0.61, 0.94) | 0.01 | 0.90 (0.82, 0.99) | — |
| AHEI-2000 | 1 [Ref] | 0.87 (0.71, 1.07) | 0.71 (0.57, 0.89) | 0.003 | 0.88 (0.80, 0.96) | 0.73 |
| HEI-2005 | 1 [Ref] | 0.94 (0.76, 1.17) | 0.75 (0.59, 0.94) | 0.01 | 0.87 (0.77, 0.99) | 0.32 |
| AHEI-2010 | 1 [Ref] | 0.81 (0.66, 0.99) | 0.77 (0.63, 0.96) | 0.02 | 0.90 (0.82, 0.98) | 0.87 |
| HEI-2010 | 1 [Ref] | 0.85 (0.69, 1.04) | 0.81 (0.65, 1.01) | 0.06 | 0.89 (0.81, 0.99) | 0.91 |
| HEI-2015 | 1 [Ref] | 0.76 (0.62, 0.94) | 0.73 (0.59, 0.91) | 0.004 | 0.87 (0.79, 0.96) | 0.40 |
| Coronary artery disease | ||||||
| HEI-1990 | 1 [Ref] | 1.07 (0.82, 1.40) | 0.96 (0.72, 1.27) | 0.76 | 0.97 (0.86, 1.09) | — |
| AHEI-2000 | 1 [Ref] | 0.99 (0.76, 1.27) | 0.61 (0.45, 0.82) | 0.002 | 0.84 (0.75, 0.95) | 0.03 |
| HEI-2005 | 1 [Ref] | 0.83 (0.63, 1.09) | 0.75 (0.56, 1.00) | 0.05 | 0.90 (0.77, 1.05) | 0.21 |
| AHEI-2010 | 1 [Ref] | 0.81 (0.62, 1.05) | 0.67 (0.50, 0.88) | 0.005 | 0.86 (0.77, 0.95) | 0.08 |
| HEI-2010 | 1 [Ref] | 0.71 (0.54, 0.93) | 0.67 (0.51, 0.89) | 0.004 | 0.84 (0.74, 0.95) | 0.04 |
| HEI-2015 | 1 [Ref] | 0.68 (0.52, 0.90) | 0.68 (0.51, 0.89) | 0.004 | 0.83 (0.74, 0.94) | 0.01 |
| Stroke | ||||||
| HEI-1990 | 1 [Ref] | 0.723 (0.49, 1.10) | 0.83 (0.56, 1.23) | 0.37 | 0.97 (0.81, 1.16) | — |
| AHEI-2000 | 1 [Ref] | 0.81 (0.54, 1.23) | 1.13 (0.75, 1.68) | 0.55 | 1.00 (0.84, 1.19) | 0.70 |
| HEI-2005 | 1 [Ref] | 1.15 (0.77, 1.71) | 0.79 (0.51, 1.22) | 0.27 | 0.88 (0.70, 1.10) | 0.26 |
| AHEI-2010 | 1 [Ref] | 0.82 (0.54, 1.23) | 1.06 (0.72, 1.57) | 0.74 | 1.00 (0.85, 1.17) | 0.67 |
| HEI-2010 | 1 [Ref] | 0.75 (0.50, 1.12) | 0.78 (0.52, 1.15) | 0.21 | 0.88 (0.73, 1.06) | 0.39 |
| HEI-2015 | 1 [Ref] | 0.84 (0.57, 1.24) | 0.70 (0.47, 1.05) | 0.09 | 0.88 (0.74, 1.05) | 0.28 |
| Heart failure | ||||||
| HEI-1990 | 1 [Ref] | 0.77 (0.53, 1.12) | 0.77 (0.54, 1.12) | 0.19 | 0.88 (0.75, 1.04) | — |
| AHEI-2000 | 1 [Ref] | 0.87 (0.61, 1.24) | 0.79 (0.54, 1.15) | 0.22 | 0.85 (0.73, 1.00) | 0.85 |
| HEI-2005 | 1 [Ref] | 0.79 (0.55, 1.13) | 0.69 (0.47, 1.00) | 0.05 | 0.81 (0.66, 1.00) | 0.53 |
| AHEI-2010 | 1 [Ref] | 0.71 (0.50, 1.01) | 0.66 (0.46, 0.94) | 0.02 | 0.83 (0.72, 0.96) | 0.62 |
| HEI-2010 | 1 [Ref] | 0.62 (0.43, 0.89) | 0.63 (0.44, 0.90) | 0.01 | 0.83 (0.70, 0.98) | 0.72 |
| HEI-2015 | 1 [Ref] | 0.48 (0.33, 0.70) | 0.65 (0.46, 0.91) | 0.01 | 0.82 (0.70, 0.96) | 0.46 |
Data presented as HRs (95% CIs) were calculated from multivariable adjusted Cox proportional hazard regression models adjusted for demographics (age, sex), health behaviors (cigarette smoking), anthropometrics (BMI), health status (diabetes status, hypertension status, HDL cholesterol, and non-HDL cholesterol), total energy intake, antihypertensive medication, and lipid-lowering medication. AHEI, Alternative Healthy Eating Index; HEI, Healthy Eating Index.
P value from test of trend across tertiles.
P value for seemingly unrelated regression for the dietary guideline adherence index compared with HEI-1990.
Cardiovascular disease is a composite outcome consisting of coronary artery disease, stroke, and heart failure.