03681nas a2200385 4500008004100000022001400041245015200055210007000207260001600277300001100293490000800304520250900312653000902821653001502830653002602845653002602871653002502897653002902922653002102951653001802972653001102990653001403001653003203015653002403047653001703071100002503088700002403113700001903137700001903156700002203175700002003197700001803217700002403235856003603259 2011 eng d a1539-370400aCirculating long-chain ω-3 fatty acids and incidence of congestive heart failure in older adults: the cardiovascular health study: a cohort study.0 aCirculating longchain ω3 fatty acids and incidence of congestive c2011 Aug 02 a160-700 v1553 a

BACKGROUND: Few previous studies have evaluated associations between long-chain ω-3 fatty acids and incidence of congestive heart failure (CHF), and those that have are typically based on diet questionnaires and yield conflicting results. Circulating fatty acid concentrations provide objective biomarkers of exposure.

OBJECTIVE: To determine whether plasma phospholipid concentrations of long-chain ω-3 fatty acids, including eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA), were associated with incident CHF.

DESIGN: Prospective cohort study.

SETTING: 4 U.S. communities.

PATIENTS: 2735 U.S. adults without prevalent heart disease who were enrolled in the Cardiovascular Health Study from 1992 to 2006.

MEASUREMENTS: Plasma phospholipid fatty acid concentrations and other cardiovascular risk factors were measured in 1992 by using standardized methods. Relationships with incident CHF (555 cases during 26 490 person-years, adjudicated by using medical records) were assessed by using Cox proportional hazards models.

RESULTS: After multivariate adjustment, plasma phospholipid EPA concentration was inversely associated with incident CHF; risk was approximately 50% lower in the highest versus the lowest quartile (hazard ratio [HR], 0.52 [95% CI, 0.38 to 0.72]; P for trend = 0.001). In similar analyses, trends toward lower risk were seen for DPA (HR, 0.76 [CI, 0.56 to 1.04]; P for trend = 0.057) and total long-chain ω-3 fatty acids (HR, 0.70 [CI, 0.49 to 0.99]; P for trend = 0.062) but not for DHA (HR, 0.84 [CI, 0.58 to 1.21]; P for trend = 0.38). In analyses censored to the middle of follow-up (7 years) to minimize exposure misclassification over time, multivariate-adjusted HRs were 0.48 for EPA (CI, 0.32 to 0.71; P for trend = 0.005), 0.61 for DPA (CI, 0.39 to 0.95; P for trend = 0.033), 0.64 for DHA (CI, 0.40 to 1.04; P for trend = 0.057), and 0.51 for total ω-3 fatty acids (CI, 0.32 to 0.80; P for trend = 0.003).

LIMITATIONS: Temporal changes in fatty acid concentrations over time may have caused underestimation of associations. Unmeasured or imperfectly measured covariates may have caused residual confounding.

CONCLUSION: Circulating individual and total ω-3 fatty acid concentrations are associated with lower incidence of CHF in older adults.

PRIMARY FUNDING SOURCE: National Institutes of Health.

10aAged10aBiomarkers10aDocosahexaenoic Acids10aEicosapentaenoic Acid10aFatty Acids, Omega-310aFatty Acids, Unsaturated10aFeeding Behavior10aHeart Failure10aHumans10aIncidence10aProportional Hazards Models10aProspective Studies10aRisk Factors1 aMozaffarian, Dariush1 aLemaitre, Rozenn, N1 aKing, Irena, B1 aSong, Xiaoling1 aSpiegelman, Donna1 aSacks, Frank, M1 aRimm, Eric, B1 aSiscovick, David, S uhttps://chs-nhlbi.org/node/130903098nas a2200421 4500008004100000022001400041245015100055210007000206260001600276300001200292490000800304520186800312653000902180653002402189653001502213653001702228653002602245653002602271653002502297653001102322653002202333653001102355653001402366653000902380653003202389653001702421653001202438100001802450700002402468700001902492700001902511700002002530700001802550700002302568700002402591700002502615856003602640 2012 eng d a1524-453900aAssociation of plasma phospholipid long-chain ω-3 fatty acids with incident atrial fibrillation in older adults: the cardiovascular health study.0 aAssociation of plasma phospholipid longchain ω3 fatty acids with c2012 Mar 06 a1084-930 v1253 a

BACKGROUND: Experimental studies suggest that long-chain n-3 polyunsaturated fatty acids (n-3 PUFAs) may reduce the risk of atrial fibrillation (AF). Prior studies evaluating fish or n-3 PUFA consumption from dietary questionnaires and incident AF have been conflicting. Circulating levels of n-3 PUFAs provide an objective measurement of exposure.

METHODS AND RESULTS: Among 3326 US men and women ≥65 years of age and free of AF or heart failure at baseline, plasma phospholipid levels of eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid were measured at baseline by use of standardized methods. Incident AF (789 cases) was identified prospectively from hospital discharge records and study visit ECGs during 31 169 person-years of follow-up (1992-2006). In multivariable Cox models adjusted for other risk factors, the relative risk in the top versus lowest quartile of total n-3 PUFAs (eicosapentaenoic acid+docosapentaenoic acid+docosahexaenoic acid) levels was 0.71 (95% confidence interval, 0.57-0.89; P for trend=0.004) and of DHA levels was 0.77 (95% confidence interval, 0.62-0.96; P for trend=0.01). Eicosapentaenoic acid and docosapentaenoic acid levels were not significantly associated with incident AF. Evaluated nonparametrically, both total n-3 PUFAs and docosahexaenoic acid showed graded and linear inverse associations with incidence of AF. Adjustment for intervening events such as heart failure or myocardial infarction during follow-up did not appreciably alter results.

CONCLUSIONS: In older adults, higher circulating total long-chain n-3 PUFA and docosahexaenoic acid levels were associated with lower risk of incident AF. These results highlight the need to evaluate whether increased dietary intake of these fatty acids could be effective for the primary prevention of AF.

10aAged10aAtrial Fibrillation10aBiomarkers10aDietary Fats10aDocosahexaenoic Acids10aEicosapentaenoic Acid10aFatty Acids, Omega-310aFemale10aFollow-Up Studies10aHumans10aIncidence10aMale10aProportional Hazards Models10aRisk Factors10aSeafood1 aH Y Wu, Jason1 aLemaitre, Rozenn, N1 aKing, Irena, B1 aSong, Xiaoling1 aSacks, Frank, M1 aRimm, Eric, B1 aHeckbert, Susan, R1 aSiscovick, David, S1 aMozaffarian, Dariush uhttps://chs-nhlbi.org/node/136203878nas 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