title: Intake of polyunsaturated fat in relation to mortality among statin users and non-users in the Southern Community Cohort Study.
abstract: OBJECTIVE
  Consumption of polyunsaturated fatty acids (PUFA), especially the n3-series, may protect against cardiovascular disease (CVD), but recent randomized studies have failed to demonstrate these benefits. One of the prevailing hypotheses is that PUFA intake may not confer benefits beyond those provided by statins, but studies comparing statin users to non-users with regard to effects of PUFA are lacking.
  
  
  RESULTS
  Black and white men and women (n = 69,559) in the Southern Community Cohort Study were studied. Cox regression models adjusting for age, sex, race, BMI, recruitment site, education, income, smoking, diabetes, and dietary variables were used.
  
  
  RESULTS
  At baseline the mean ± SD age was 52 ± 9 years, 60% of participants were women, 54% had hypertension and 16% used statins. We observed modest inverse associations between n3-PUFA and n6-PUFA intake with mortality among non-statin users but not among statin users. In adjusted analyses, the HRs (95% CIs) for all-cause mortality (6,396 deaths over a median of 6.4 years) comparing the highest to the lowest quintile were 0.90 (0.82-1.00) for n3-PUFA and 0.80 (0.70-0.92) for n6-PUFA among non-statin users, whereas they were 1.06 (0.87-1.28) and 0.96 (0.78-1.19) for n3-PUFA and n6-PUFA, respectively, among statin users.
  
  
  CONCLUSIONS
  Our results suggest potential benefits of PUFA consumption on mortality which are only apparent in the absence of statin therapy. It seems prudent to consider the potential benefit of PUFA consumption in the primary prevention of CVD among patients who are not candidates for statin therapy but are at increased risk for CVD and mortality.
authors: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: kiagejn@gmail.com.
authors: J N
authors: JN
authors: Kiage
authors: Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda, MD 30105, USA. Electronic address: uchechukwu.sampson@nih.gov.
authors: U K A
authors: UK
authors: Sampson
authors: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA; Vanderbilt Center for Translational and Clinical Cardiovascular Research, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: loren.lipworth@vanderbilt.edu.
authors: L
authors: L
authors: Lipworth
authors: The Knight Cardiovascular Institute, Center for Preventive Cardiology, Oregon Health and Science University, Portland, OR 97239, USA. Electronic address: fazio@ohsu.edu.
authors: S
authors: S
authors: Fazio
authors: Center for Translation Research and Implementation Science (CTRIS), National Heart, Lung, and Blood Institute, Bethesda, MD 30105, USA. Electronic address: george.mensah@nih.gov.
authors: G A
authors: GA
authors: Mensah
authors: Westat, Rockville, MD 20850, USA. Electronic address: qiluyu@westat.com.
authors: Q
authors: Q
authors: Yu
authors: The International Epidemiology Institute, Rockville, MD 20850, USA. Electronic address: heather@iei.us.
authors: H
authors: H
authors: Munro
authors: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA; Vanderbilt Center for Translational and Clinical Cardiovascular Research, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: elvis.a.akwo@vanderbilt.edu.
authors: E A
authors: EA
authors: Akwo
authors: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: qi.dai@vanderbilt.edu.
authors: Q
authors: Q
authors: Dai
authors: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA; The International Epidemiology Institute, Rockville, MD 20850, USA. Electronic address: william.j.blot@vanderbilt.edu.
authors: W J
authors: WJ
authors: Blot
authors: Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37203, USA; Vanderbilt Center for Translational and Clinical Cardiovascular Research, Vanderbilt University Medical Center, Nashville, TN 37203, USA. Electronic address: edmond.kabagambe@vanderbilt.edu.
authors: E K
authors: EK
authors: Kabagambe
mesh_terms: D000328:Adult; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000188:drug therapy* / Q000401:mortality*; D015331:Cohort Studies; D004032:Diet; D002149:Energy Intake; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D043371:Fatty Acids, Omega-6 / Q000008:administration & dosage*; D005260:Female; D005399:Fishes; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D016016:Proportional Hazards Models; D011446:Prospective Studies; D017747:Seafood; D012959:Socioeconomic Factors
chemical_list: D015525:Fatty Acids, Omega-3; D043371:Fatty Acids, Omega-6; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Cardiovascular disease; Fish; Hypertension; Mortality; PUFA; Prospective