A prospective study of plasma fish oil levels and incidence of myocardial infarction in U.S. male physicians

Division of Preventive Medicine, Brigham and Women's Hospital, Boston Massachusetts.

OBJECTIVES. This study evaluated whether increased intake of fish oils (eicosapentaenoic and docosahexaenoic acids) might reduce the risk of coronary heart disease. BACKGROUND. Observational and clinical studies have suggested that increased intake of fish oils, as reflected in plasma levels of fish oils, may reduce the risk of myocardial infarction. METHODS. A nested case-control study was conducted among the 14,916 participants in the Physicians' Health Study with a sample of plasma before randomization. Each participant with myocardial infarction occurring during the first 5 years of follow-up was matched by smoking status and age with a randomly chosen control participant who had not developed coronary heart disease. RESULTS. Mean levels of fish oils (with 95% confidence interval [CI] for paired differences and p values) in case and control participants, expressed as percent of total fatty acids, were, for eicosapentaenoic acid, 0.26 versus 0.25 (95% CI -0.03 to 0.05, p = 0.70) in cholesterol esters and 0.56 versus 0.54 (95% CI -0.04 to 0.09, p = 0.44) in phospholipids, and for docosahexaenoic acid, 0.23 versus 0.24 (95% CI -0.07 to 0.04, p = 0.64) in cholesterol esters and 2.22 versus 2.14 (95% CI -0.10 to 0.27, p = 0.36) in phospholipids. Results adjusted for major cardiovascular risk factors showed a very similar lack of association between fish oil levels and the incidence of myocardial infarction. CONCLUSIONS. These results indicate no beneficial effect of increased fish oil consumption on the incidence of a first myocardial infarction. However, the effect of very high levels of fish oils could not be evaluated.

This article has been cited by other articles:

				Q. Sun, J. Ma, H. Campos, K. M Rexrode, C. M Albert, D. Mozaffarian, and F. B Hu Blood concentrations of individual long-chain n-3 fatty acids and risk of nonfatal myocardial infarction Am. J. Clinical Nutrition, July 1, 2008; 88(1): 216 - 223. [Abstract] [Full Text] [PDF]

				W. S Harris The omega-3 index as a risk factor for coronary heart disease Am. J. Clinical Nutrition, June 1, 2008; 87(6): 1997S - 2002S. [Abstract] [Full Text] [PDF]

				U. J. Jung, C. Torrejon, A. P Tighe, and R. J Deckelbaum n-3 Fatty acids and cardiovascular disease: mechanisms underlying beneficial effects Am. J. Clinical Nutrition, June 1, 2008; 87(6): 2003S - 2009S. [Abstract] [Full Text] [PDF]

				Q. Sun, J. Ma, H. Campos, S. E Hankinson, and F. B Hu Comparison between plasma and erythrocyte fatty acid content as biomarkers of fatty acid intake in US women Am. J. Clinical Nutrition, July 1, 2007; 86(1): 74 - 81. [Abstract] [Full Text] [PDF]

				R. J. Hogg, L. Fitzgibbons, C. Atkins, N. Nardelli, R. C. Bay, and for the North American IgA Nephropathy Study Group Efficacy of Omega-3 Fatty Acids in Children and Adults with IgA Nephropathy Is Dosage- and Size-Dependent Clin. J. Am. Soc. Nephrol., November 1, 2006; 1(6): 1167 - 1172. [Abstract] [Full Text] [PDF]

				K. He, Y. Song, M. L. Daviglus, K. Liu, L. Van Horn, A. R. Dyer, and P. Greenland Accumulated Evidence on Fish Consumption and Coronary Heart Disease Mortality: A Meta-Analysis of Cohort Studies Circulation, June 8, 2004; 109(22): 2705 - 2711. [Abstract] [Full Text] [PDF]

				D. W. Nilsen and W. S Harris n-3 Fatty acids and cardiovascular disease Am. J. Clinical Nutrition, January 1, 2004; 79(1): 166 - 166. [Full Text] [PDF]

				A. T Erkkila, S. Lehto, K. Pyorala, and M. I. Uusitupa n-3 Fatty acids and 5-y risks of death and cardiovascular disease events in patients with coronary artery disease Am. J. Clinical Nutrition, July 1, 2003; 78(1): 65 - 71. [Abstract] [Full Text] [PDF]

				E. Guallar, M. I. Sanz-Gallardo, P. v.'t Veer, P. Bode, A. Aro, J. Gomez-Aracena, J. D. Kark, R. A. Riemersma, J. M. Martin-Moreno, F. J. Kok, et al. Mercury, Fish Oils, and the Risk of Myocardial Infarction N. Engl. J. Med., November 28, 2002; 347(22): 1747 - 1754. [Abstract] [Full Text] [PDF]

				C. M. Albert, H. Campos, M. J. Stampfer, P. M. Ridker, J. E. Manson, W. C. Willett, and J. Ma Blood Levels of Long-Chain n-3 Fatty Acids and the Risk of Sudden Death N. Engl. J. Med., April 11, 2002; 346(15): 1113 - 1118. [Abstract] [Full Text] [PDF]

				A. Tavani, C. Pelucchi, E. Negri, M. Bertuzzi, and C. La Vecchia n-3 Polyunsaturated Fatty Acids, Fish, and Nonfatal Acute Myocardial Infarction Circulation, November 6, 2001; 104(19): 2269 - 2272. [Abstract] [Full Text] [PDF]

				D. W. Nilsen, G. Albrektsen, K. Landmark, S. Moen, T. Aarsland, and L. Woie Effects of a high-dose concentrate of n-3 fatty acids or corn oil introduced early after an acute myocardial infarction on serum triacylglycerol and HDL cholesterol Am. J. Clinical Nutrition, July 1, 2001; 74(1): 50 - 56. [Abstract] [Full Text] [PDF]

				D.S. Siscovick, T.E. Raghunathan, R. Lemaitre, I. King, and L.A. Cobb Long-chain n-3 polyunsaturated fatty acids and out-of-hospital primary cardiac arrest: clinical and public health implications of observational studies and clinical trials Eur. Heart J. Suppl., June 1, 2001; 3(suppl_D): D70 - D74. [Abstract] [PDF]

				W. S. Harris and J. H. O'Keefe Jr Invited Review: Cardioprotective Effects of {omega}-3 Fatty Acids Nutr Clin Pract, February 1, 2001; 16(1): 6 - 12. [Abstract] [PDF]

				T. Rissanen, S. Voutilainen, K. Nyyssonen, T. A. Lakka, and J. T. Salonen Fish Oil-Derived Fatty Acids, Docosahexaenoic Acid and Docosapentaenoic Acid, and the Risk of Acute Coronary Events : The Kuopio Ischaemic Heart Disease Risk Factor Study Circulation, November 28, 2000; 102(22): 2677 - 2679. [Abstract] [Full Text] [PDF]

				D. S Siscovick, T. Raghunathan, I. King, S. Weinmann, V. E Bovbjerg, L. Kushi, L. A Cobb, M. K Copass, B. M Psaty, R. Lemaitre, et al. Dietary intake of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest Am. J. Clinical Nutrition, January 1, 2000; 71(1): 208S - 212S. [Abstract] [Full Text] [PDF]

				E. Fernandez, L. Chatenoud, C. La Vecchia, E. Negri, and S. Franceschi Fish consumption and cancer risk Am. J. Clinical Nutrition, July 1, 1999; 70(1): 85 - 90. [Abstract] [Full Text] [PDF]

				E. Guallar, A. Aro, F. J. Jimenez, J. M. Martin-Moreno, I. Salminen, P. van't Veer, A. F. M. Kardinaal, J. Gomez-Aracena, B. C. Martin, L. Kohlmeier, et al. Omega-3 Fatty Acids in Adipose Tissue and Risk of Myocardial Infarction : The EURAMIC Study Arterioscler Thromb Vasc Biol, April 1, 1999; 19(4): 1111 - 1118. [Abstract] [Full Text] [PDF]

				C. M. Albert, C. H. Hennekens, C. J. O'Donnell, U. A. Ajani, V. J. Carey, W. C. Willett, J. N. Ruskin, and J. E. Manson Fish Consumption and Risk of Sudden Cardiac Death JAMA, January 7, 1998; 279(1): 23 - 28. [Abstract] [Full Text] [PDF]

				P. Marckmann, E.-M. Bladbjerg, and J. Jespersen Dietary Fish Oil (4 g Daily) and Cardiovascular Risk Markers in Healthy Men Arterioscler Thromb Vasc Biol, December 1, 1997; 17(12): 3384 - 3391. [Abstract] [Full Text]

				N. J. Stone Fish Consumption, Fish Oil, Lipids, and Coronary Heart Disease Circulation, November 1, 1996; 94(9): 2337 - 2340. [Full Text]

				B. L. Rodriguez, D. S. Sharp, R. D. Abbott, C. M. Burchfiel, K. Masaki, P.-H. Chyou, B. Huang, K. Yano, and J. D. Curb Fish Intake May Limit the Increase in Risk of Coronary Heart Disease Morbidity and Mortality Among Heavy Smokers: The Honolulu Heart Program Circulation, September 1, 1996; 94(5): 952 - 956. [Abstract] [Full Text]

				A. Ascherio, E. B. Rimm, M. J. Stampfer, E. L. Giovannucci, and W. C. Willett Dietary Intake of Marine n-3 Fatty Acids, Fish Intake, and the Risk of Coronary Disease among Men N. Engl. J. Med., April 13, 1995; 332(15): 977 - 983. [Abstract] [Full Text] [PDF]