131 Virgin Olive Oil Benefits 10.2. Extra virgin olive oil and vascular risk factors The main risk factors for cardiovascular disease have traditionally been classified as either modifiable or non-modifiable. Age, gender, and genetic inheritance are considered non-modifiable factors given that we cannot act upon them. In contrast, other risk factors such as arterial hypertension, lipid disorders (dyslipidaemias), diabetes mellitus, obesity, and tobacco consumption are all modified. We will focus here on the relationship between olive oil consumption and blood pressure, dyslipidaemias, and diabetes mellitus. The link between olive oil consumption and obesity will be addressed in another chapter, whilst tobacco consumption is beyond the scope of this publication. -Arterial hypertension High blood pressure is a principal risk factor for stroke (cerebrovascular attack), myocardial infarction, sudden death, heart failure, peripheral vascular disease, and renal failure. The primary guidelines for controlling blood pressure include reducing body weight and salt consumption, encouraging physical activity, and moderating alcohol intake for those who consume alcohol. An increase in the consumption of fruit, vegetables, and fish is also advisable within the context of a healthy dietary pattern, such as the Mediterranean diet. Olive oil, particularly EVOO, has also been shown to reduce blood pressure both in cohort and intervention studies. The large sample size Greek cohort of the EPIC (“European Prospective Investigation into Cancer and Nutrition”) study included 28,572 volunteers, aged 26 to 86. The relationship between olive oil consumption and blood pressure was analysed. It was observed that of the 26,913 participants with normal blood pressure those with higher adherence to the Mediterranean diet presented both lower systolic and diastolic blood pressure. An increase in the consumption of olive oil, fruit, and vegetable was associated with lower blood pressure, whereas the intake of cereals, meat, and alcohol was linked with higher blood pressure. The authors concluded that olive oil consumption not only decreased blood pressure but also encouraged the intake of other blood pressure-reducing foods, such as vegetables. In the SUN (University of Navarra Follow-up) study, the first 6803 participants presented a 4.7% cumulative incidence of hypertension in males, and an inverse relationship was observed between olive oil consumption and blood pressure, with less hypertension at high levels of olive oil consumption. In the PREDIMED (PREvencion con DIeta MEDiterranea; Prevention with Mediterranean Diet) study, ambulatory blood pressure was monitored during 24 hours (by Holter System) in 235 subjects at high vascular risk (85.4% of them with
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