Abstract 3607: Plasma ω-3 polyunsaturated fatty acids associated with reduced risk of heart failure among women: the Atherosclerosis Risk In Communities (ARIC) Study
BACKGROUND A previous prospective study showed that dietary intakes of fish or ω-3 polyunsaturated fatty acids (PUFA) were associated with reduced risk of heart failure (HF), but no study has examined the association between plasma ω-3 PUFA and HF. Our a priori hypothesis was that plasma ω-3 PUFA would be inversely associated with incident HF.
METHODS We included 3,592 white participants from the Minneapolis field center of the ARIC Study, aged 45– 64 at baseline (1987– 89), initially free of coronary heart disease, stroke and HF. Fractions of plasma cholesterol ester (CE) and phospholipid (PL) ω-3 PUFA of marine origin (eicosapentaenoic acid [EPA], ω-3 docosapentaenoic acid [DPA] and docosahexaenoic acid [DHA]) were measured by gas-liquid chromatography. The subjects were followed through 2003, and incident HF was defined by a hospital discharge or death including a HF ICD code. The hazard ratio and 95% confidence interval (HR [95%CI]) for HF was calculated according to quintiles of CE and PL fractions of ω-3 PUFA.
RESULTS During the 14.3-year follow-up, we identified 197 cases of CHF (110 for men and 87 for women). After adjustment for age and potential risk factors (smoking, pack-years, alcohol consumption, body mass index, systolic blood pressure, antihypertensive medication use, plasma total cholesterol, diabetes and total energy intake), the incidence of HF for women was associated inversely and linearly with ω-3 PUFA in the PL fraction (HR for highest quintile vs lowest quintile was 0.27 [0.12– 0.63], p for trend <0.001). There was a similar tendency for the CE fraction for women (HR=0.45 [0.20 –1.03], p for trend =0.08). No associations were observed for men (interaction for gender p=0.04 for PL fraction).
CONCLUSIONS We found a significant inverse association between plasma ω-3 PUFA and incident HF among women, consistent with a prior study using a food frequency questionnaire. Contrary to our hypothesis, however, no such association was observed for men.