Cost-benefit analysis of mediterranean diet and medication in chronic heart failure patients

Evangelia Tzorovili, Christina Chrysohoou, Evelina Bei, Konstantinos Konstantinou, Androniki Filippou, Stylianos Iosifidis, Demosthenes B. Panagiotakos, Dimitrios Tousoulis



Introduction: Long-term adherence to the Mediterranean dietary pattern has been recognized to contribute to cardiovascular disease (CVD) prevention. The purpose of this study was to estimate the cost-benefit of the Mediterranean diet as compared to standard medication therapy in patients with chronic heart failure, in reducing cardiovascular events. The study endpoints were the incidence of combined CVD event (death and rehospitalization) at 6 and 12 months.
Material & Methods: 263 consecutive, hospitalized patients (63 ± 13 years, 84% men) were enrolled. The total cost of the Mediterranean diet was calculated in €/month based on the diet pyramid’s portion recommendations as outlined by the Ministry of Health and Welfare (1999). The level of adherence was measured with the MedDietScore dietary score. The cost of medication was calculated in €/month and included anticoagulants and antihypertensive agents, statins, beta-blockers, ACE-antagonists, diuretics and drugs for treating diabetes mellitus.
Results: The average monthly cost of full adherence to the Mediterranean diet was 178.63€, while the average monthly cost of medication was 77.10€. Increased adherence to the Mediterranean diet was associated with reduced risk of cardiovascular episode 1-year post-hospitalization (0.96, 95%CI 0.92, 1.00). For every 10 more Euros spent to maintain the Mediterranean diet in relation to medication, the risk for CVD events was reduced by 19% (p = 0.09).
Conclusions: The present analysis suggests that healthy eating is both an effective and economic model to reduce cardiovascular events in patients with chronic heart failure, under optimal medical therapy.

Keywords: acute coronary syndrome, heart failure, Mediterranean diet, medication, secondary prevention