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on March 10, 2003

Circulation. 2003
Published online before print March 10, 2003, doi: 10.1161/01.CIR.0000055315.79177.16
A more recent version of this article appeared on March 18, 2003
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Submitted on September 30, 2002
Revised on December 10, 2002
Accepted on December 10, 2002

Cardiac Benefits of Fish Consumption May Depend on the Type of Fish Meal Consumed. The Cardiovascular Health Study

Dariush Mozaffarian MD*, Rozenn N. Lemaitre PhD, MPH, Lewis H. Kuller MD, DrPH, Gregory L. Burke MD, MS, Russell P. Tracy PhD, and David S. Siscovick MD, MPH

From the Cardiovascular Health Research Unit, Departments of Medicine (R.L., D.S.) and Epidemiology (D.S.) and Division of Cardiology (D.M.), University of Washington, and the Veterans Affairs Puget Sound Health Care Center (D.M.), Seattle, Wash; the Department of Epidemiology (L.K.), Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pa; the Department of Public Health Sciences (G.B.), Wake Forest University School of Medicine, Winston-Salem, NC; and the Laboratory for Clinical Biochemistry Research (R.T.), Department of Pathology, University of Vermont, Colchester, Vt.

* To whom correspondence should be addressed. E-mail: darymd{at}hotmail.com.

Background--Few studies have examined associations of fish consumption with ischemic heart disease (IHD) risk among older adults or how different types of fish meals relate to IHD risk.

Methods and Results--In a population-based prospective cohort study, usual fish consumption was ascertained at baseline among 3910 adults aged >=65 years and free of known cardiovascular disease in 1989 and 1990. Consumption of tuna and other broiled or baked fish correlated with plasma phospholipid long-chain n-3 fatty acids, whereas consumption of fried fish or fish sandwiches (fish burgers) did not. Over 9.3 years' mean follow-up, there were 247 IHD deaths (including 148 arrhythmic deaths) and 363 incident nonfatal myocardial infarctions (MIs). After adjustment for potential confounders, consumption of tuna or other broiled or baked fish was associated with lower risk of total IHD death (P for trend=0.001) and arrhythmic IHD death (P=0.001) but not nonfatal MI (P=0.44), with 49% lower risk of total IHD death and 58% lower risk of arrhythmic IHD death among persons consuming tuna/other fish 3 or more times per week compared with less than once per month. In similar analyses, fried fish/fish sandwich consumption was not associated with lower risk of total IHD death, arrhythmic IHD death, or nonfatal MI but rather with trends toward higher risk.

Conclusions--Among adults aged >=65 years, modest consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches, is associated with lower risk of IHD death, especially arrhythmic IHD death. Cardiac benefits of fish consumption may vary depending on the type of fish meal consumed.


Key words: diet • fatty acids • coronary disease • arrhythmia




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