The results of several unrelated studies point to the cardioprotective effects of nut consumption and fibrate use, but not the pneumonia vaccine.

In one project, the authors reviewed the effects of dietary nut intake on blood lipids in 25 clinical trials involving 583 men and women aged 19 to 86 years (Arch Intern Med. 2010;170:821-827). None of the participants was taking lipid-lowering medications at the time.

With an average daily intake of various nuts of 2.4 oz (67 g), total and LDL levels fell by 5.1% and 7.4%, respectively, but HDL levels were not significantly affected. Triglycerides fell 10.2% among those with high levels at baseline. Overall, the people with the highest levels of LDL, lowest BMI, and greatest consumption of Western diets enjoyed the greatest lipid-lowering benefits from eating nuts.

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Another meta-analysis (Lancet. 2010;375:1875-1884) explored the impact of fibrates on vascular issues. Although these agents are known to raise HDL and lower triglycerides, and could lower LDL, their influence on such cardiovascular events as heart attack and stroke is unclear.

The examination of 45,058 participants in a total of 18 trials showed fibrate therapy to produce a 10% relative risk (RR) reduction for major cardiovascular events and a 13% RR reduction for coronary events. Fibrates also reduced the risk of albuminuria progression by 14%. However, the drugs had no statistically significant effect on stroke, all-cause mortality, cardiovascular mortality, or sudden death.

Although a number of studies have shown that influenza shots can reduce the risk of vascular events, the idea that pneumonia vaccination provides the same benefits has proven controversial. The concept received no support from the findings of a prospective cohort study of 84,170 men aged 45 to 69 years: In this group, administration of the pneumococcal vaccine was not shown to reduce risk of acute heart attack or stroke (JAMA. 2010;303:1699-1706).