***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background / Objectives : Evidence about the relation between dietary patterns and cardiovascular disease ( CVD ) is scarce in Middle Eastern countries . This study was performed to examine the association between major dietary patterns and  CVD mortality in Iranian adults . Subjects/ Methods : This population -based prospect i ve cohort study was conducted among 4834 r and omly selected participants aged ⩾35 years from urban and rural areas of central Iran ( 2001–2009 ) ( the Isfahan Cohort Study ) .  Dietary intakes were assessed using a food frequency question naire , and major dietary patterns were identified by means of exploratory factor analysis . Subjects or their next of kin were interviewed biannually looking for possible occurrence of events . Cardiovascular mortality was defined as fatal myocardial infa rct ion , fatal stroke and sudden cardiac death . Results : During the median follow-up of 9.0 years and 50 282 person-years , we found a total of 118 CVD mortalities . Four major dietary patterns were identified : ' Western ' , ' Mediterranean ' , ' Animal fat ' and ' Fast food ' . Adherence to the Mediterranean dietary pattern was protectively associated with CVD mortality , such that those in the highest quartile were 46 % ( hazard ratio ( HR ) : 0.54 ; 95 % confidence interval ( CI ) : 0.32–0.91 ; P-value for trend=0.03 ) less likely to have incident CVD mortality than those in the lowest quartile . Further adjustment for potential confounders strengthened this association ( HR : 0.42 ; 95 % CI : 0.19–0.96 ; P-value for trend=0.02 ) . We found no significant association between adherence to the Western , animal fat and fast food dietary patterns and CVD mortality . Conclusions : Adherence to a Mediterranean dietary pattern was associated with reduced risk for cardiovascular mortality even in a developing country setting Diet rich in fruits , vegetables , and dairy products , known as the Dietary Approaches to Stop Hypertension ( DASH ) diet , is known to reduce blood pressure  ( BP ) in hypertensive patients . More recently , the DASH diet was shown to reduce oxidative stress in hypertensive and nonhypertensive humans . However , the main nutritional components responsible for these beneficial effects of the DASH diet remain unknown . Because the DASH diet is rich in potassium ( K ) , magnesium ( Mg ) , and alkali , we performed a r and omized , double-blinded , placebo-controlled study to compare effects of potassium magnesium citrate ( KMgCit ) , potassium chloride ( KCl ) , and potassium citrate ( KCit ) to allow dissociation of the three components of K , Mg , and citrate on 24-hour ambulatory BP and urinary 8-isoprostane in hypertensive and prehypertensive subjects , using a r and omized crossover design . We found that KCl supplementation for 4 weeks induced a significant reduction in nighttime SBP compared with placebo ( 116 ± 12 vs 121 ± 15 mm Hg , respectively , p < 0.01 vs placebo ) , whereas KMgCit and KCit had no significant effect in the same subjects ( 118 ± 11 and 119 ± 13 mm Hg , respectively , p > 0.1 vs placebo ) . In contrast , urinary 8-isoprostane was significantly reduced with KMgCit powder compared with placebo ( 13.5 ± 5.7 vs 21.1 ± 10.5 ng/mgCr , respectively , p < 0.001 ) , whereas KCl and KCit had no effect ( 21.4 ± 9.1 and 18.3 ± 8.4 , respectively , p > 0.1 vs placebo ) . In conclusion , our study demonstrated differential effects of  KCl  and KMgCit supplementation on BP and the oxidative stress marker in prehypertensive and hypertensive subjects . Clinical significance of the antioxidative effect of KMgCit remains to be determined in future studies OBJECTIVES This study sought to determine the efficacy of dietary sodium restriction ( DSR ) for improving vascular endothelial dysfunction in middle-aged/older adults with moderately elevated systolic blood pressure ( SBP ) ( 130 - 159 mm Hg ) and the associated physiological mechanisms . BACKGROUND Vascular endothelial dysfunction develops with advancing age and elevated SBP , contributing to increased cardiovascular risk . DSR lowers BP , but its effect on vascular endothelial function and mechanisms involved are unknown . METHODS Seventeen subjects ( 11 men and 6 women ; mean age , 62 ± 7 years ) completed a , r and omized crossover study of 4 weeks of both low ( DSR ) and normal sodium intake . Vascular endothelial function ( endothelium-dependent dilation ; EDD ) , nitric oxide (NO)/tetrahydrobiopterin ( BH(4 ) ) bioavailability , and oxidative stress-associated mechanisms were assessed following each condition . RESULTS Urinary sodium excretion was reduced by ≈ 50 % ( to 70 ± 30 mmol/day ) , and conduit ( brachial artery flow-mediated dilation [ FMD(BA ) ] ) and resistance ( forearm blood flow responses to acetylcholine [ FBF(ACh ) ] ) artery EDD were 68 % and 42 % ( peak FBF(ACh ) ) higher following DSR ( p < 0.005 ) . Low sodium markedly enhanced NO-mediated EDD ( greater ΔFBF(ACh ) with endothelial NO synthase inhibition ) without changing endothelial NO synthase expression/activation ( Ser 1177 phosphorylation ) , restored BH(4 ) bioactivity ( less ΔFMD(BA ) with acute BH(4 ) ) , abolished tonic superoxide suppression of EDD ( less ΔFMD(BA ) and ΔFBF(ACh ) with ascorbic acid infusion ) , and increased circulating superoxide dismutase activity ( all p < 0.05 ) . These effects were independent of ΔSBP . Other subject characteristics/dietary factors and endothelium-independent dilation were unchanged . CONCLUSIONS DSR largely reversed both macro- and microvascular endothelial dysfunction by enhancing NO and BH(4 ) bioavailability and reducing oxidative stress . Our findings support the emerging concept that DSR induces " vascular protection " beyond that attributable to its BP-lowering effects BACKGROUND The incidence of congestive heart failure ( CHF ) has been increasing steadily in the United States during the past 2 decades . We studied risk factors for CHF and their corresponding attributable risk in the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study . PARTICIPANTS AND METHODS A total of 13 643 men and women without a history of CHF at baseline examination were included in this prospect i ve cohort study . Risk factors were measured using st and ard methods between 1971 and 1975 . Incidence of CHF was assessed using medical records and death certificates obtained between 1982 and 1984 and in 1986 , 1987 , and 1992 . RESULTS During average follow-up of 19 years , 1382 CHF cases were documented . Incidence of CHF was positively and significantly associated with male sex ( relative risk [ RR ] , 1.24 ; 95 % confidence interval [ CI ] , 1.10 - 1.39 ; P<.001 ; population attributable risk [ PAR ] , 8.9 % ) , less than a high school education ( RR , 1.22 ; 95 % CI , 1.04 - 1.42 ; P = .01 ; PAR , 8.9 % ) , low physical activity ( RR , 1.23 ; 95 % CI , 1.09 - 1.38 ; P<.001 ; PAR , 9.2 % ) , cigarette smoking ( RR , 1.59 ; 95 % CI , 1.39 - 1.83 ; P<.001 ; PAR , 17.1 % ) , overweight ( RR , 1.30 ; 95 % CI , 1.12 - 1.52 ; P = .001 ; PAR , 8.0 % ) , hypertension ( RR , 1.40 ; 95 % CI , 1.24 - 1.59 ; P<.001 ; PAR , 10.1 % ) , diabetes ( RR , 1.85 ; 95 % CI , 1.51 - 2.28 ; P<.001 ; PAR , 3.1 % ) , valvular heart disease ( RR , 1.46 ; 95 % CI , 1.17 - 1.82 ; P = .001 ; PAR , 2.2 % ) , and coronary heart disease ( RR , 8.11 ; 95 % CI , 6.95 - 9.46 ; P<.001 ; PAR , 61.6 % ) . CONCLUSIONS Male sex , less education , physical inactivity , cigarette smoking , overweight , diabetes , hypertension , valvular heart disease , and coronary heart disease are all independent risk factors for CHF . More than 60 % of the CHF that occurs in the US general population might be attributable to coronary heart disease Background Despite convincing evidence in the Mediterranean region , the cardiovascular benefit of the Mediterranean diet is not well established in non-Mediterranean countries and the optimal criteria for defining adherence are unclear . The population attributable fraction ( PAF ) of adherence to this diet is also unknown . Methods In the UK-based EPIC-Norfolk prospect i ve cohort , we evaluated habitual diets assessed at baseline ( 1993–1997 ) and during follow-up ( 1998–2000 ) using food-frequency question naires  ( n = 23,902 ) . We estimated a Mediterranean diet score ( MDS ) using cut-points projected from the Mediterranean dietary pyramid , and also three other pre-existing MDSs . Using multivariable-adjusted Cox regression with repeated measures of MDS and covariates , we examined prospect i ve associations between each MDS with incident cardiovascular diseases ( CVD ) by 2009 and mortality by 2013 , and estimated PAF for each outcome attributable to low MDS . Results We observed 7606 incident CVD events ( 2818/100,000 person-years ) and 1714 CVD deaths ( 448/100,000 ) . The MDS based on the Mediterranean dietary pyramid was significantly associated with lower incidence of the cardiovascular outcomes , with hazard ratios ( 95 % confidence intervals ) of 0.95 ( 0.92–0.97 ) per one st and ard deviation for incident CVD and 0.91 ( 0.87–0.96 ) for CVD mortality . Associations were similar for composite incident ischaemic heart disease and all-cause mortality . Other pre-existing MDSs showed similar , but more modest associations . PAF due to low dietary pyramid based MDS ( < 95th percentile ) was 3.9 % ( 1.3–6.5 % ) for total incident CVD and 12.5 % ( 4.5–20.6 % ) for CVD mortality . Conclusions Greater adherence to the Mediterranean diet was associated with lower CVD incidence and mortality  in the UK . This diet has an important population health impact for the prevention of CVD BACKGROUND The possible advantage for weight loss of a diet that emphasizes protein , fat , or carbohydrates has not been established , and there are few studies that extend beyond 1 year . METHODS We r and omly assigned 811 overweight adults to one of four diets ; the targeted percentages of energy derived from fat , protein , and carbohydrates in the four diets were 20 , 15 , and 65 % ; 20 , 25 , and 55 % ; 40 , 15 , and 45 % ; and 40 , 25 , and 35 % . The diets consisted of similar foods and met guidelines for cardiovascular health . The participants were offered group and individual instructional sessions for 2 years . The primary outcome was the change in body weight after 2 years in two-by-two factorial comparisons of low fat versus high fat and average protein versus high protein and in the comparison of highest and lowest carbohydrate content . RESULTS At 6 months , participants assigned to each diet had lost an average of 6 kg , which represented 7 % of their initial weight ; they began to regain weight after 12 months . By 2 years , weight loss remained similar in those who were assigned to a diet with 15 % protein and those assigned to a diet with 25 % protein ( 3.0 and 3.6 kg , respectively ) ; in those assigned to a diet with 20 % fat and those assigned to a diet with 40 % fat ( 3.3 kg for both groups ) ; and in those assigned to a diet with 65 % carbohydrates and those assigned to a diet with 35 % carbohydrates ( 2.9 and 3.4 kg , respectively ) ( P>0.20 for all comparisons ) . Among 
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The DASH pattern showed improvement in cardiac function , functional capacity , blood pressure , oxidative stress and mortality .
The Mediterranean diet had a correlation with inflammation , quality of life and cardiac function but just on cross-sectional studies .
Conclusions : DASH pattern may have benefits in the secondary prevention of HF .
In addition , the Hyperproteic and Low-carb diets , despite the lack of studies , also demonstrated positive effects on the functional capacity in patients with HF