related to CVDs, an amount that corresponds to 33 percent of its hospitalization expenditures.

Through well-accepted risk factors (i.e., dyslipidemia, hypertension), dietary factors have a prominent role in the genesis of athersclerotic CVDs (i.e., CHD, stroke, heart failure³ ). Although atherosclerosis is a chronic process beginning in youth, there is abundant evidence that therapies initiated in older-aged persons can prevent or delay clinical events. Furthermore, because of the high incidence of CVD events in older age, even relatively small improvements in risk factors (i.e., small reductions in blood pressure and low-density lipoprotein [LDL] cholesterol through diet), should be of substantial benefit to the general population. However, there is a lag period, likely 2 or more years, between the onset of therapy and a reduced risk of clinical events, such as CHD and stroke. The situation is quite different for heart failure, in which case adherence to dietary and medication therapies can lead to early benefits, such as reduced rate of hospitalization and reduced length of stay.

The following sections discuss the role of diet as a means to improve cardiovascular risk factors (dyslipidemia and hypertension) and as a means to treat heart failure.

Dyslipidemia is a powerful risk factor for atherosclerotic diseases, particularly CHD. The term dyslipidemia applies to a high blood level of