Coronary Artery Disease Clinical Trial
Official title:
Effects Of Almonds On Vascular Reactivity And Biomarkers Of Inflammation, Oxidative Stress And Endothelial Function In Patients With Coronary Artery Disease
The vascular endothelium (inner lining of cells in blood vessels) normally prevents
vasospasm and thrombosis by production of a variety of regulatory substances, including
nitric oxide. In patients with atherosclerosis, these functions of the endothelium are
impaired and these abnormalities may contribute to the development of heart attack and
stroke.
Observational studies have shown that frequent nut consumption decreases the risk of
cardiovascular disease (CVD), but the mechanisms of benefit have not been fully defined.
Recent studies suggest that specific fatty acids and flavonoids in nuts may have favorable
effects on cardiovascular disease. In addition, there is growing evidence that these
compounds may improve the function of the endothelium.
The present study is designed to test the hypothesis that an almond-enriched diet will
improve the function of the endothelium in patients with coronary artery disease. Subjects
will be enrolled into a randomized, placebo-controlled, crossover study that will compare a
National Cholesterol Education Program Step 1 diet without nuts to a Step 1 diet that has
the same number of total calories but includes 3 ounces of almonds daily. Participants will
consume each diet for six weeks with a four-week rest period between diets. The order of
diets will be randomized (almonds or no almonds). Dietary assessments via food recall
questionnaires will be employed at the study entry, end of the four week washout period, and
end of the second intervention. If subjects are drifting from the recommendations of the
STEP 1 diet, counseling will be given to urge compliance. The primary endpoint will be
endothelium-dependent flow- mediated dilation assessed by ultrasound. Secondary study
outcomes will include lipid profiles, markers of inflammation and oxidative stress.
Enrollment will continue until 40 subjects with complete data are available.
Patients will be enrolled at Boston Medical Center and the Jean Mayer US Department of
Agriculture Human Nutrition Research Center at Tufts Medical Center. Dietary interventions
will be performed at Tufts Medical Center or by telephone. Ultrasound studies and blood
collection will be performed in the principal investigator's research unit at Boston Medical
Center.
n/a
Allocation: Randomized, Intervention Model: Crossover Assignment, Masking: Open Label
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