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

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.