Role of Polyunsaturated Fat in Modifying Cardiovascular Risk Associated With Family History of Cardiovascular Disease: Pooled De Novo Results From 15 Observational Studies

Author:

Laguzzi Federica1ORCID,Åkesson Agneta1ORCID,Marklund Matti23ORCID,Qian Frank45ORCID,Gigante Bruna6ORCID,Bartz Traci M.78ORCID,Bassett Julie K.9,Birukov Anna1011ORCID,Campos Hannia12,Hirakawa Yoichiro13,Imamura Fumiaki14ORCID,Jäger Susanne10,Lankinen Maria15ORCID,Murphy Rachel A.1617ORCID,Senn Mackenzie1819ORCID,Tanaka Toshiko20,Tintle Nathan2122ORCID,Virtanen Jyrki K.15ORCID,Yamagishi Kazumasa2324,Allison Matthew25ORCID,Brouwer Ingeborg A.2627ORCID,De Faire Ulf1ORCID,Eiriksdottir Gudny.28ORCID,Ferrucci Luigi20ORCID,Forouhi Nita G.14ORCID,Geleijnse Johanna M.29ORCID,Hodge Allison M930ORCID,Kimura Hitomi2324ORCID,Laakso Markku3132ORCID,Risérus Ulf33ORCID,van Westing Anniek C.1829,Bandinelli Stefania34,Baylin Ana35ORCID,Giles Graham G.93036ORCID,Gudnason Vilmundur2837ORCID,Iso Hiroyasu3839ORCID,Lemaitre Rozenn N.8ORCID,Ninomiya Toshiharu13,Post Wendy S.240ORCID,Psaty Bruce M.84142ORCID,Salonen Jukka T.4344,Schulze Matthias B.1011ORCID,Tsai Michael Y.45ORCID,Uusitupa Matti15ORCID,Wareham Nicholas J.14ORCID,Oh Seung-Won46ORCID,Wood Alexis C.18ORCID,Harris William S.2147,Siscovick David48ORCID,Mozaffarian Dariush49ORCID,Leander Karin1ORCID,

Affiliation:

1. Unit of Cardiovascular and Nutritional Epidemiology, Institute of Environmental Medicine (F.L., A.A., U.D.F., K.L.), Karolinska Institutet, Stockholm, Sweden.

2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (M.M., W.S.P).

3. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, Australia (M.M.).

4. Section of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian and Avedisian School of Medicine, MA (F.Q.).

5. Department of Nutrition (F.Q.), Boston, MA.

6. Cardiovascular Medicine Unit, Department of Medicine Solna (B.G.), Karolinska Institutet, Stockholm, Sweden.

7. Cardiovascular Health Research Unit, Departments of Biostatistics (T.M.B.), University of Washington, Seattle.

8. Medicine (T.M.B., R.N.L., B.M.P.), University of Washington, Seattle.

9. Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Australia (J.K.B., A.M.H., G.G.G.).

10. Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal (A.K.B., S.J., M.B.S.).

11. German Center for Diabetes Research, Neuherberg (A.K.B., S.J., M.B.S.).

12. Harvard T.H. Chan School of Public Health (H.C.), Boston, MA.

13. Departments of Epidemiology and Public Health and Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan (Y.H., T.N.).

14. Medical Research Council Epidemiology Unit, University of Cambridge School of Clinical Medicine, UK (F.I., N.G.F., N.J.W.).

15. Institutes of Public Health and Clinical Nutrition (M. Lankinen, J.K.V., M.U.), University of Eastern Finland, Kuopio.

16. Cancer Control Research, BC Cancer Agency, Vancouver, Canada (R.A.M.).

17. School of Population and Public Health, University of British Columbia, Vancouver, Canada (R.A.M.).

18. United States Department of Agriculture/Agricultural Research Service Children’s Nutrition Research Center, Baylor College of Medicine, Houston, TX (M.S., A.C.W.).

19. Institute of Nutritional Science, University of Potsdam, Nuthetal, Germany (M.B.S.).

20. Longitudinal Study Section, National Institute on Aging, Baltimore, MD (T.T., L.F.).

21. Fatty Acid Research Institute, Sioux Falls, SD (N.T., W.S.H.).

22. Department of Population Health Nursing Science, University of Illinois – Chicago (N.T.).

23. Department of Public Health Medicine, Institute of Medicine (K.Y., H.K.), University of Tsukuba, Japan.

24. Health Services Research and Development Center (K.Y., H.K.), University of Tsukuba, Japan.

25. Department of Family Medicine, University of California, San Diego, La Jolla (M.A.).

26. Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, The Netherlands (I.A.B.).

27. Amsterdam Public Health Research Institute, The Netherlands (I.A.B.).

28. Icelandic Heart Association, Kopavogur (G.E., V.G.).

29. Division of Human Nutrition and Health, Wageningen University and Research, The Netherlands (J.M.G., A.C.v.W.).

30. Centre for Epidemiology and Biostatistics, University of Melbourne, Victoria, Australia (A.M.H., G.G.G.).

31. Clinical Medicine, Internal Medicine (M. Laakso), University of Eastern Finland, Kuopio.

32. Kuopio University Hospital (M. Laakso), University of Eastern Finland, Kuopio.

33. Department of Public Health and Caring Sciences, Clinical Nutrition and Metabolism, Uppsala University, Sweden (M.M., U.R).

34. Geriatric Unit, Azienda Unità Sanitaria Locale Toscana Centro, Florence, Italy (S.B.).

35. University of Michigan School of Public Health, Ann Arbor (A. Baylin).

36. Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Victoria, Australia (G.G.G.).

37. Faculty of Medicine, University of Iceland, Reykjavik (V.G.).

38. Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan (H.I.).

39. Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan (H.I.).

40. Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD (W.S.P.).

41. Epidemiology (B.M.P.), University of Washington, Seattle.

42. Health Systems and Population Health (B.M.P.), University of Washington, Seattle.

43. Metabolic Analytical Services Oy, Helsinki, Finland (J.T.S.).

44. University of Helsinki, the Faculty of Medicine, Department of Public Health, Finland (J.T.S.).

45. Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis (M.Y.T.).

46. Department of Family Medicine, Seoul National University College of Medicine, and Healthcare System Gangnam Center, Seoul National University Hospital, Republic of Korea (S.W.O.).

47. Department of Internal Medicine, Sanford School of Medicine, University of South Dakota, Sioux Falls (W.S.H.).

48. The New York Academy of Medicine, New York (D.S.).

49. Food Is Medicine Institute, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).

Abstract

BACKGROUND: It is unknown whether dietary intake of polyunsaturated fatty acids (PUFA) modifies the cardiovascular disease (CVD) risk associated with a family history of CVD. We assessed interactions between biomarkers of low PUFA intake and a family history in relation to long-term CVD risk in a large consortium. METHODS: Blood and tissue PUFA data from 40 885 CVD-free adults were assessed. PUFA levels ≤25th percentile were considered to reflect low intake of linoleic, alpha-linolenic, and eicosapentaenoic/docosahexaenoic acids (EPA/DHA). Family history was defined as having ≥1 first-degree relative who experienced a CVD event. Relative risks with 95% CI of CVD were estimated using Cox regression and meta-analyzed. Interactions were assessed by analyzing product terms and calculating relative excess risk due to interaction. RESULTS: After multivariable adjustments, a significant interaction between low EPA/DHA and family history was observed (product term pooled RR, 1.09 [95% CI, 1.02–1.16]; P =0.01). The pooled relative risk of CVD associated with the combined exposure to low EPA/DHA, and family history was 1.41 (95% CI, 1.30–1.54), whereas it was 1.25 (95% CI, 1.16–1.33) for family history alone and 1.06 (95% CI, 0.98–1.14) for EPA/DHA alone, compared with those with neither exposure. The relative excess risk due to interaction results indicated no interactions. CONCLUSIONS: A significant interaction between biomarkers of low EPA/DHA intake, but not the other PUFA, and a family history was observed. This novel finding might suggest a need to emphasize the benefit of consuming oily fish for individuals with a family history of CVD.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

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