The highest quartile of serum EPA and DHA levels was associated with a lower risk of total cardiovascular mortality compared to the lowest quartile (HR 0.71; 95% CI 0.59-0.86).
Cohort (n=6,464)
No
Do high serum EPA and DHA levels reduce total cardiovascular mortality in individuals without baseline cardiovascular disease?
In individuals without baseline CVD, high serum EPA and DHA levels are associated with a 29% lower risk of cardiovascular mortality over a 22-year follow-up.
Effect estimate: HR 0.71 (95% CI 0.59-0.86)
Abstract Background Omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been linked to cardiovascular (CV) health. However, the long-term relationship between serum EPA + DHA levels and territory-specific CV mortality is unclear. We therefore aimed to investigate the association between serum EPA + DHA levels and the incidence of total and arterial territory-specific CV mortality. Methods From the EPIC-Norfolk prospective population study (N = 25,639), we included 6,464 participants without baseline cardiovascular disease (CVD) in whom EPA and DHA plasma levels (i.e. the sum of serum EPA and DHA as mol% of total fatty acids) were available. In short, EPIC-Norfolk included individuals aged 45-79 years between 1993 and 1997 from the county of Norfolk (UK). Follow-up mortality data were available until March 15, 2022. The primary outcome of interest was total CV mortality, and secondary outcomes included mortality from ischemic heart disease (IHD), stroke (ischemic, hemorrhagic, or unspecified), peripheral artery disease (PAD) and aortic aneurysm (AA). Cox proportional hazards regression models were used to calculate hazard ratios (HRs) (95% confidence intervals CIs), comparing extreme quartiles of EPA + DHA levels; EPA and DHA quartiles were also analyzed separately. Models were adjusted for age, sex, ethnicity, physical activity, smoking status, LDL cholesterol, systolic blood pressure, BMI, diabetes status, and omega-6 polyunsaturated fatty acids (sum of linoleic plus arachidonic acids). Results In 6,464 individuals (52% women, mean age 63 years SD 8) with a median follow-up of 22.1 years (IQR 13.3–26.1), 979 CV (15%) deaths occurred. IHD was the most common cause of mortality (8.4%), followed by stroke (5.4%). Compared to the lowest quartile, participants in the highest EPA+DHA quartile had a lower risk of total CV mortality (HR 0.71, 95% CI 0.59–0.86), mortality from IHD (HR 0.73, 95% CI 0.57–0.95), stroke (HR 0.70, 95% CI 0.51 – 0.97), AA (HR 0.55, 95% CI 0.27–1.12) and PAD (HR 0.63, 95% CI 0.17–2.37). When analyzed separately, EPA and DHA alone showed similar associations with total CV mortality (HR 0.69, 95% CI 0.55–0.87 and HR 0.74, 95% CI 0.62–0.89, respectively) and territory-specific causes of mortality (Figure). Conclusion In apparently healthy individuals, serum EPA + DHA levels in the highest quartile were inversely associated with CV mortality compared to the lowest quartile over a median follow-up of 22 years. This association remained consistent across all arterial territories, despite low mortality from AA and PAD. These findings suggest a protective effect of EPA and DHA on cardiovascular health, underscoring their potential role in the etiology of cardiovascular diseases.
Bollen et al. (Sat,) conducted a cohort in Without baseline cardiovascular disease (n=6,464). Highest quartile of serum EPA + DHA levels vs. Lowest quartile of serum EPA + DHA levels was evaluated on Total cardiovascular mortality (HR 0.71, 95% CI 0.59-0.86). The highest quartile of serum EPA and DHA levels was associated with a lower risk of total cardiovascular mortality compared to the lowest quartile (HR 0.71; 95% CI 0.59-0.86).