Circulating Long-Chain ω-3 Fatty Acids and Incidence of Congestive Heart Failure in Older Adults: The Cardiovascular Health Study

Funded by: National Institutes of Health

Dariush Mozaffarian, MD, DrPH; et. al. Annals of Internal Medicine. 2011;155:160-170.

Julianna L. MurphyPharm.D. CandidatePreceptor: Ali Rahimi, MD, FACP-AGSFAugust 19, 2011

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.

ω-3 Fatty AcidsEssential fatty acidsReduce inflammationMay reduce risk for chronic

diseases, including heart diseaseHave also been used for:

◦Dyslipidemia◦Hypertension◦Diabetes mellitus

Study Design and Patient PopulationMulticenter, prospective cohortConducted over a 13-year period5,888 ambulatory, non-

institutionalized adults recruited in 4 U.S. communities

2,735 participants analyzedAll data collected from 1992 to

1993 visit and blood sampleStandardized procedure for CHF confirmation

Participant CriteriaAge 65+ yearsWithin the 4 recruitment

communitiesExclusions:

◦Diagnosed CHF at time of enrollment◦Presence of coronary heart disease

or other serious cardiovascular illness

Measurements and OutcomePlasma phospholipid fatty acid

concentrations measured in 1992 samples

Relationships with incident CHF assessed using Cox proportional hazards models

Other cardiovascular risk factors were similarly analyzed

ResultsPlasma EPA concentration

inversely associated with CHF, with hazard ratio (HR) of 0.52

Lower risk trends also found with DPA (HR = 0.76) and total ω-3 fatty acid levels (HR = 0.70)

DHA levels not found to be inversely associated with incident CHF

Results

ConclusionHigher levels of circulating ω-3

fatty acids are associated with a lower incidence of congestive heart failure in older adults

CommentsLimitations

◦Fatty acid concentrations measured only once

◦Possible presence of additional confounders

◦Study sample only from 4 communities in the United States

◦Dietary recall performed once, at time of enrollment

Level of Evidence/Grade of Recommendation

Level IIb Grade B