title: Circulating long-chain ω-3 fatty acids and incidence of congestive heart failure in older adults: the cardiovascular health study: a cohort study.
abstract: 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.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  4 U.S. communities.
  
  
  METHODS
  2735 U.S. adults without prevalent heart disease who were enrolled in the Cardiovascular Health Study from 1992 to 2006.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  Temporal changes in fatty acid concentrations over time may have caused underestimation of associations. Unmeasured or imperfectly measured covariates may have caused residual confounding.
  
  
  CONCLUSIONS
  Circulating individual and total ω-3 fatty acid concentrations are associated with lower incidence of CHF in older adults.
  
  
  BACKGROUND
  National Institutes of Health.
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, and Harvard School of Public Health, Boston, Massachusetts 02115, USA. dmozaffa@hsph.harvard.edu
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
authors.forename: Rozenn N
authors.initials: RN
authors.lastname: Lemaitre
authors.forename: Irena B
authors.initials: IB
authors.lastname: King
authors.forename: Xiaoling
authors.initials: X
authors.lastname: Song
authors.forename: Donna
authors.initials: D
authors.lastname: Spiegelman
authors.forename: Frank M
authors.initials: FM
authors.lastname: Sacks
authors.forename: Eric B
authors.initials: EB
authors.lastname: Rimm
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D004281:Docosahexaenoic Acids / Q000097:blood; D015118:Eicosapentaenoic Acid / Q000097:blood; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D005231:Fatty Acids, Unsaturated / Q000097:blood; D005247:Feeding Behavior; D006333:Heart Failure / Q000097:blood* / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D005231:Fatty Acids, Unsaturated; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid; C026219:docosapentaenoic acid