docosapentaenoic-acid and Heart-Failure

Data on the relation of plasma and dietary omega-3 (n-3) fatty acids (FAs) with heart failure (HF) risk have been inconsistent.. We evaluated the relation of n-3 FAs with HF in US male physicians.. We used nested case-control (n = 1572) and prospective cohort study designs (n = 19,097). Plasma phospholipid n-3 FAs were measured by using gas chromatography, and food-frequency questionnaires were used to assess dietary n-3 FAs and fish intake. Incident HF was ascertained via annual follow-up questionnaires and validated in a subsample.. The mean age was 58.7 y at blood collection. In a multivariable model, plasma α-linolenic acid (ALA) was associated with a lower risk of HF in a nonlinear fashion (P-quadratic trend = 0.02), and the lowest OR was observed in quintile 4 (0.66; 95% CI: 0.47, 0.94). Plasma EPA and DHA were not associated with HF, whereas plasma docosapentaenoic acid (DPA) showed a nonlinear inverse relation with HF for quintile 2 (OR: 0.55; 95% CI: 0.39, 0.79). Dietary marine n-3 FAs showed a trend toward a lower risk of HF in quintile 4 (HR: 0.81; 95% CI: 0.64, 1.02) and a nonlinear pattern across quintiles. Fish intake was associated with a lower risk of HF, with RRs of ~0.70 for all categories of fish consumption greater than one serving per month.. Our data are consistent with an inverse and nonlinear relation of plasma phospholipid ALA and DPA, but not EPA or DHA, with HF risk. Fish consumption greater than once per month was associated with a lower HF risk.

Topics: Aged; alpha-Linolenic Acid; Animals; Case-Control Studies; Cohort Studies; Diet; Double-Blind Method; Fatty Acids, Omega-3; Fatty Acids, Unsaturated; Female; Fishes; Follow-Up Studies; Heart Failure; Humans; Incidence; Male; Middle Aged; Physicians; Risk; Seafood; United States

Studies have previously examined the relation between a single measure of plasma fatty acids and risk of heart failure. However, it is unclear whether the use of repeated measures of fatty acids over time is required for the assessment of omega-3 fatty acids heart failure relation.. Using a nested case-control design, this ancillary study used 421 cases and 421 matched controls from the Physicians' Health Study to assess the variability of plasma phospholipid fatty acids over time and compare the results of omega-3 fatty acids heart failure associations using a single versus repeated measurements of plasma phospholipid fatty acids. Plasma omega-3 fatty acids were measured at baseline (1982) and approximately 15 years later using gas chromatography.. Spearman's correlation coefficients between baseline and follow-up measures of α-linolenic acid (ALA), EPA, DPA, and DHA were 0.20, 0.45, 0.28, and 0.50, respectively, in the control series. Multivariable adjusted odds ratios for heart failure per standard deviation higher plasma ALA were 0.98 (95% CI 0.85-1.13) when using baseline ALA and 0.86 (95% CI 0.74-1.01) when using the average of baseline and follow-up ALA measurements. Corresponding odds ratios for total long chain omega-3 FAs (EPA + DHA + DPA) were 0.87 (0.73-1.03) and 0.88 (0.75-1.04).. Our data demonstrate modest correlation between measurements of plasma phospholipid fatty acids spaced by 15 years. A single measurement of plasma phospholipid fatty acids appears reasonable to estimate the risk of heart failure over long-term follow-up.

Topics: Aged; alpha-Linolenic Acid; Body Mass Index; Case-Control Studies; Chromatography, Gas; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fatty Acids, Unsaturated; Follow-Up Studies; Heart Failure; Humans; Male; Middle Aged; Phospholipids; Prospective Studies; Risk Factors

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.. 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.. Prospective cohort study.. 4 U.S. communities.. 2735 U.S. adults without prevalent heart disease who were enrolled in the Cardiovascular Health Study from 1992 to 2006.. 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.. 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).. Temporal changes in fatty acid concentrations over time may have caused underestimation of associations. Unmeasured or imperfectly measured covariates may have caused residual confounding.. Circulating individual and total ω-3 fatty acid concentrations are associated with lower incidence of CHF in older adults.. National Institutes of Health.

Topics: Aged; Biomarkers; Docosahexaenoic Acids; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Fatty Acids, Unsaturated; Feeding Behavior; Heart Failure; Humans; Incidence; Proportional Hazards Models; Prospective Studies; Risk Factors