von Willebrand factor, a possible indicator of endothelial cell damage, decreases during long‐term compliance with a lipid‐lowering diet

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Abstract
Objectives. To test whether serum von Willebrand factor (vWf) would be lower in men with atherosclerosis who had been consuming a lipid‐lowering diet for 3 years than in a control group of men with atherosclerosis who had been following their normal diet. Design. A randomized, population‐based case‐control study. Setting. A tertiary health care referral centre at a University Hospital. Subjects. Men age less than 66 years with angiographically proven coronary atherosclerosis and a cholesterol level > 6 mmol L−1. Sixty started the study and 50 completed it. Interventions. Subjects were randomized to a lipid‐lowering diet or to taking their normal diet for approximately 3 years. Main outcome measures. The components of the subjects' diets were assessed and blood was obtained for total, low‐density lipoprotein (LDL) and high‐density lipoprotein (HDL) cholesterol, triglycerides and for vWf. Results. Men on the lipid‐lowering diet consumed less total, saturated and monounsaturated fats (all P < 0.001), cholesterol and retinol (both P < 0.002) but increased polyunsaturated fats (P < 0.001), fibre, vitamin E (both P < 0.005) and carbohydrate (P < 0.05). Those on the lipid‐lowering diet also had lower serum levels of total and LDL cholesterol (P < 0.002 and P < 0.05, respectively), triglycerides (P < 0.02) and vWf (P < 0.05) than the men on their normal diet. There was no difference in HDL cholesterol. Levels of vWf correlated with both total cholesterol (P < 0.005) and inversely with dietary polyunsaturated fats (P < 0.02). Conclusion. von Willebrand factor, a possible indicator of endothelial cell damage, decreases during long‐term compliance with a lipid‐lowering diet.