Vegetables and Artichokes Production and Cardiovascular and Cerebrovascular Diseases Mortality: An Ecological Study

Cardiovascular disease (CDV), including cerebrovascular disease (CED) and ischemic heart disease (IHD) are multifactorial etiology. Several epidemiological approaches could be employed to prevent morbidity and mortality. With an ecological design, we analyzed mortality of CVD, CED, and IHD from 8 municipalities of Castellon's province with more than 20,000 inhabitants, in the Valencia Community (Spain) during the period 1991-2011, to estimate if the vegetables and artichokes production may be associated with lower CVD mortality. A municipality, Benicarló, highlighted the higher production of vegetables and artichokes, where artichokes are the main agricultural product (variety Cynara scolymus).  In a multilevel linear regression analysis adjusted for potential confounding factors, vegetables and artichokes production was associated with reduced CED mortality and, to a lesser extent, CVD mortality. No significant effect on IHD mortality was found. In biological research, artichokes reduce total cholesterol, low-density lipoprotein cholesterol, triglyceride levels, and blood pressure. However, among other limitations, we postulated vegetables and artichoke production as a proxy of their consumption. In conclusion, the study found an inverse association between vegetables and artichoke production and CVD and CED mortality, and new studies are needed to confirm these results.