n−3 Polyunsaturated fatty acids, fatal ischemic heart disease, and nonfatal myocardial infarction in older adults: the Cardiovascular Health Study123

https://doi.org/10.1093/ajcn/77.2.319Get rights and content
Under an Elsevier user license
open archive

ABSTRACT

Background:

Little is known about the relation of the dietary intake of n−3 polyunsaturated fatty acids, ie, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) from fatty fish and α-linolenic acid from vegetable oils, with ischemic heart disease among older adults.

Objective:

We investigated the associations of plasma phospholipid concentrations of DHA, EPA, and α-linolenic acid as biomarkers of intake with the risk of incident fatal ischemic heart disease and incident nonfatal myocardial infarction in older adults.

Design:

We conducted a case-control study nested in the Cardiovascular Health Study, a cohort study of adults aged ≥ 65 y. Cases experienced incident fatal myocardial infarction and other ischemic heart disease death (n = 54) and incident nonfatal myocardial infarction (n = 125). Matched controls were randomly selected (n = 179). We measured plasma phospholipid concentrations of n−3 polyunsaturated fatty acids in blood samples drawn ≈2 y before the event.

Results:

A higher concentration of combined DHA and EPA was associated with a lower risk of fatal ischemic heart disease, and a higher concentration of α-linolenic acid with a tendency to lower risk, after adjustment for risk factors [odds ratio: 0.32 (95% CI: 0.13, 0.78; P = 0.01) and 0.52 (0.24, 1.15; P = 0.1), respectively]. In contrast, n−3 polyunsaturated fatty acids were not associated with nonfatal myocardial infarction.

Conclusions:

Higher combined dietary intake of DHA and EPA, and possibly α-linolenic acid, may lower the risk of fatal ischemic heart disease in older adults. The association of n−3 polyunsaturated fatty acids with fatal ischemic heart disease, but not with nonfatal myocardial infarction, is consistent with possible antiarrhythmic effects of these fatty acids.

KEY WORDS

Fatty acids
n−3 fatty acids
phospholipids
ischemic heart disease
myocardial infarction
nested case-control studies
docosahexaenoic acid
eicosapentaenoic acid
older adults
Cardiovascular Health Study

Cited by (0)

1

From the Cardiovascular Health Research Unit, Departments of Medicine (RNL, DM, and DSS) and Epidemiology (DSS), University of Washington, Seattle; the Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle (IBK); the Health Services Program, Puget Sound Veterans Affairs Medical Center, Seattle (DM); the Department of Epidemiology, University of Pittsburgh (LHK); and the Department of Pathology, University of Vermont, Cholchester (RPT).

2

Supported by contracts N01-HC-85079 through N01-HC-85086, N01-HC-35129, and N01-HC-15103 from the National Heart, Lung, and Blood Institute.

3

Address reprint requests to RN Lemaitre, Cardiovascular Health Research Unit, Metropolitan Park, East Tower, Suite 1360, 1730 Minor Avenue, Seattle, WA 98101. E-mail: [email protected].