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J Am Coll Cardiol, 2005; 45:2015-2021, doi:10.1016/j.jacc.2005.03.038 © 2005 by the American College of Cardiology Foundation |
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* Channing Laboratory, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, and the Departments of Nutrition and Epidemiology, Harvard School of Public Health, Boston, Massachusetts
Veterans Affairs Puget Sound Health Care System, University of Washington, Seattle, Washington
Cardiovascular Health Research Unit, University of Washington, Seattle, Washington
Department of Medicine, University of Washington, Seattle, Washington
|| Department of Epidemiology, University of Washington, Seattle, Washington
¶ Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
Manuscript received December 26, 2004; revised manuscript received March 8, 2005, accepted March 10, 2005.
* Reprint requests and correspondence: Dr. Dariush Mozaffarian, 665 Huntington Avenue, Building 2, Room 315, Boston, Massachusetts 02115. (Email: dmozaffa{at}hsph.harvard.edu).
Abstract presented at the American Heart Association Conference on Cardiovascular Disease Epidemiology and Prevention, San Francisco, California, March 2004.
OBJECTIVES: Our aim was to investigate the relation between fish consumption and incidence of congestive heart failure (CHF).
BACKGROUND: The incidence and health burden of CHF are rising, particularly in older persons. Although n-3 fatty acids have effects that could favorably influence risk of CHF, the relation between fish intake and CHF incidence is unknown.
METHODS: Among 4,738 adults age 
65 years and free of CHF at baseline in 1989–90, usual dietary intake was assessed using a food frequency questionnaire. In a participant subsample, consumption of tuna or other broiled or baked fish, but not fried fish, correlated with plasma phospholipid n-3 fatty acids. Incidence of CHF was prospectively adjudicated.
RESULTS: During 12 years’ follow-up, 955 participants developed CHF. In multivariate-adjusted analyses, tuna/other fish consumption was inversely associated with incident CHF, with 20% lower risk with intake 1 to 2 times/week (hazard ratio [HR] = 0.80, 95% confidence interval [CI] = 0.64 to 0.99), 31% lower risk with intake 3 to 4 times/week (HR = 0.69, 95% CI = 0.52 to 0.91), and 32% lower risk with intake 5 times/week (HR = 0.68, 95% CI = 0.45 to 1.03), compared with intake <1 time/month (p trend = 0.009). In similar analyses, fried fish consumption was positively associated with incident CHF (p trend = 0.01). Dietary long-chain n-3 fatty acid intake was also inversely associated with CHF (p trend = 0.009), with 37% lower risk in the highest quintile of intake (HR = 0.73, 95% CI = 0.57 to 0.94) compared with the lowest.
CONCLUSIONS: Among older adults, consumption of tuna or other broiled or baked fish, but not fried fish, is associated with lower incidence of CHF. Confirmation in additional studies and evaluation of potential mechanisms is warranted.
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