Blood Levels of Long-Chain n3 Fatty Acids and the Risk of Sudden Death
Christine M. Albert, M.D., M.P.H., Hannia Campos, Ph.D., Meir J. Stampfer, M.D., Dr.P.H., Paul M. Ridker, M.D., M.P.H., JoAnn E. Manson, M.D., Dr.P.H., Walter C. Willett, M.D., Dr.P.H., and Jing Ma, M.D., Ph.D.
Background Experimental data suggest that long-chain n3polyunsaturated fatty acids found in fish have antiarrhythmicproperties, and a randomized trial suggested that dietary supplementsof n3 fatty acids may reduce the risk of sudden deathamong survivors of myocardial infarction. Whether long-chainn3 fatty acids are also associated with the risk of suddendeath in those without a history of cardiovascular disease isunknown.
Methods We conducted a prospective, nested casecontrolanalysis among apparently healthy men who were followed forup to 17 years in the Physicians' Health Study. The fatty-acidcomposition of previously collected blood was analyzed by gasliquidchromatography for 94 men in whom sudden death occurred as thefirst manifestation of cardiovascular disease and for 184 controlsmatched with them for age and smoking status.
Results Base-line blood levels of long-chain n3 fattyacids were inversely related to the risk of sudden death bothbefore adjustment for potential confounders (P for trend = 0.004)and after such adjustment (P for trend = 0.007). As comparedwith men whose blood levels of long-chain n3 fatty acidswere in the lowest quartile, the relative risk of sudden deathwas significantly lower among men with levels in the third quartile(adjusted relative risk, 0.28; 95 percent confidence interval,0.09 to 0.87) and the fourth quartile (adjusted relative risk,0.19; 95 percent confidence interval, 0.05 to 0.71).
Conclusions The n3 fatty acids found in fish are stronglyassociated with a reduced risk of sudden death among men withoutevidence of prior cardiovascular disease.
Source Information
From the Division of Preventive Medicine (C.M.A., P.M.R., J.E.M.), the Channing Laboratory (M.J.S., J.E.M., W.C.W., J.M.), and the Division of Cardiovascular Medicine (P.M.R.), Department of Medicine, Brigham and Women's Hospital; the Cardiovascular Division, Department of Medicine, Massachusetts General Hospital (C.M.A.); and the Departments of Nutrition (H.C., M.J.S., W.C.W.) and Epidemiology (M.J.S., J.E.M., W.C.W.), Harvard School of Public Health all in Boston.
Address reprint requests to Dr. Albert at the Division of Preventive Medicine, Brigham and Women's Hospital, 900 Commonwealth Ave. East, Boston, MA 02215-1204, or at calbert{at}partners.org.
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