03878nas a2200433 4500008004100000022001400041245012400055210007000179260001600249300001100265490000800276520264600284653000902930653001502939653001902954653002102973653001702994653002603011653002603037653002503063653002903088653002103117653001103138653001103149653000903160653002403169653002003193653001103213100002503224700002403249700001903273700001903292700001903311700002003330700001803350700001603368700002403384856003603408 2013 eng d a1539-370400aPlasma phospholipid long-chain ω-3 fatty acids and total and cause-specific mortality in older adults: a cohort study.0 aPlasma phospholipid longchain ω3 fatty acids and total and cause c2013 Apr 02 a515-250 v1583 a

BACKGROUND: Long-chain ω-3 polyunsaturated fatty acids (ω3-PUFAs), including eicosapentaenoic acid (EPA) (20:5ω-3), docosapentaenoic acid (DPA) (22:5ω-3), and docosahexaenoic acid (DHA) (22:6ω-3), have been shown to reduce cardiovascular risk, but effects on cause-specific and total mortality and potential dose-responses remain controversial. Most observational studies have assessed self-reported dietary intake and most randomized trials have tested effects of adding supplements to dietary intake and evaluated secondary prevention, thus limiting inference for dietary ω3-PUFAs or primary prevention.

OBJECTIVE: To investigate associations of plasma phospholipid EPA, DPA, DHA, and total ω3-PUFA levels with total and cause-specific mortality among healthy older adults not receiving supplements.

DESIGN: Prospective cohort study.

SETTING: 4 U.S. communities.

PARTICIPANTS: 2692 U.S. adults aged 74 years (±5 years) without prevalent coronary heart disease (CHD), stroke, or heart failure at baseline.

MEASUREMENTS: Phospholipid fatty acid levels and cardiovascular risk factors were measured in 1992. Relationships with total and cause-specific mortality and incident fatal or nonfatal CHD and stroke through 2008 were assessed.

RESULTS: During 30 829 person-years, 1625 deaths (including 570 cardiovascular deaths), 359 fatal and 371 nonfatal CHD events, and 130 fatal and 276 nonfatal strokes occurred. After adjustment, higher plasma levels of ω3-PUFA biomarkers were associated with lower total mortality, with extreme-quintile hazard ratios of 0.83 for EPA (95% CI, 0.71 to 0.98; P for trend = 0.005), 0.77 for DPA (CI, 0.66 to 0.90; P for trend = 0.008), 0.80 for DHA (CI, 0.67 to 0.94; P for trend = 0.006), and 0.73 for total ω3-PUFAs (CI, 0.61 to 0.86; P for trend < 0.001). Lower risk was largely attributable to fewer cardiovascular than noncardiovascular deaths. Individuals in the highest quintile of phospholipid ω3-PUFA level lived an average of 2.22 more years (CI, 0.75 to 3.13 years) after age 65 years than did those in the lowest quintile.

LIMITATION: Temporal changes in fatty acid levels and misclassification of causes of death may have resulted in underestimated associations, and unmeasured or imperfectly measured covariates may have caused residual confounding.

CONCLUSION: Higher circulating individual and total ω3-PUFA levels are associated with lower total mortality, especially CHD death, in older adults.

PRIMARY FUNDING SOURCE: National Institutes of Health.

10aAged10aBiomarkers10aCause of Death10aCoronary Disease10aDiet Records10aDocosahexaenoic Acids10aEicosapentaenoic Acid10aFatty Acids, Omega-310aFatty Acids, Unsaturated10aFeeding Behavior10aFemale10aHumans10aMale10aProspective Studies10aRisk Assessment10aStroke1 aMozaffarian, Dariush1 aLemaitre, Rozenn, N1 aKing, Irena, B1 aSong, Xiaoling1 aHuang, Hongyan1 aSacks, Frank, M1 aRimm, Eric, B1 aWang, Molin1 aSiscovick, David, S uhttps://chs-nhlbi.org/node/6079