Fish consumption and risk of stroke, coronary heart disease, and cardiovascular mortality in a Dutch population with low fish intake

Background_Long-term randomized trials of interventions on fish and primary prevention of coronary heart disease (CHD) are unavailable. The parametric g-formula uses observational data to estimate the effect of changes on fish consumption that would have been observed under hypothetical interventions. Methods and Results_Among 53,799 women from the Nurses’ Health Study aged 39-67 and free of CHD at baseline in 1986, 1,891 developed incident CHD (1,145 non fatal, 830 fatal) by 2008. Women provided information on risk factors and medical conditions every 2 years and on diet every 4 years. We used the parametric g-formula to evaluate hypothetical interventions from baseline forward on fish intake. Specifically, we estimated the CHD risks if all women had changed their fish intake to zero servings per week, and if all women had changed their fish intake to at least 1, 2, 3 and 5 servings per week during the entire follow-up. We adjusted for age and family history of CHD, and for baseline and time-varying menopausal status, use of oral contraceptives, postmenopausal hormone therapy, aspirin, multivitamin and vitamin E supplements, diabetes, hypertension, hypercholesterolemia, stroke, angina or CABG, BMI, physical activity, smoking and intake of calories, trans fatty acids, cereal fiber and red meat. The estimated CHD risk was 4.13 if fish intake had been changed to zero after 1986, and 3.77, 3.53, 3.32 and 3.35, if all women had changed their fish intake to at least 1, 2, 3 and 5 servings per week, respectively. Compared with changing fish intake to zero, the risk ratio of CHD was 0.85 (95% CI 0.75, 0.91) for changing intake to at least 2 servings/week, and 0.80 (95% CI 0.71, 0.97) for changing intake to at least 3 servings. This estimated protective effect of increased fish consumption was restricted to fatal CHD. Results were not appreciably altered when we specified that red meat was replaced by fish intake. Conclusion_Our results suggest that increasing fish consumption in mid or later life may lower the 22-year risk of CHD in women by 20%. Using the parametric g-formula allowed to explicitly specify hypothetical interventions to evaluate the effectiveness of diet change over a long period. Like all observational estimates, the parametric g-formula estimates may be affected by unmeasured confounding, model misspecification, and measurement error.

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Fish Intake May Limit the Increase in Risk of Coronary Heart Disease Morbidity and Mortality Among Heavy Smokers

Circulation ◽

10.1161/01.cir.94.5.952 ◽

1996 ◽

Vol 94 (5) ◽

pp. 952-956 ◽

Cited By ~ 82

Author(s):

Beatriz L. Rodriguez ◽

Dan S. Sharp ◽

Robert D. Abbott ◽

Cecil M. Burchfiel ◽

Kamal Masaki ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Fish Intake ◽

Morbidity And Mortality ◽

Increase In Risk ◽

Heavy Smokers

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Dietary Soy Consumption and Cardiovascular Mortality among Chinese People with Type 2 Diabetes

Nutrients ◽

10.3390/nu13082513 ◽

2021 ◽

Vol 13 (8) ◽

pp. 2513

Author(s):

Xiaowen Wang ◽

Jun Lv ◽

Canqing Yu ◽

Liming Li ◽

Yonghua Hu ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Heart Disease ◽

Heart Disease ◽

Food Consumption ◽

Cardiovascular Mortality ◽

International Classification Of Diseases ◽

Cardiovascular Death ◽

Soy Foods ◽

Cox Proportional Hazard Regression

Randomized controlled trials showed that soy intervention significantly improved blood lipids in people with diabetes. We sought to prospectively examine the association of soy consumption with the risk of cardiovascular death among individuals with diabetes. A total of 26,139 participants with a history of diabetes were selected from the Chinese Kadoorie Biobank study. Soy food consumption was assessed by a food frequency questionnaire. Causes of death were coded by the 10th International Classification of Diseases. The Cox proportional hazard regression was used to compute the hazard ratios. During a median follow-up of 7.8 years, a total of 1626 deaths from cardiovascular disease (CVD) were recorded. Compared with individuals who never consumed soy foods, the multivariable-adjusted risks (95% confidence intervals) of CVD mortality were 0.92 (0.78, 1.09), 0.89 (0.75, 1.05), and 0.77 (0.62, 0.96) for those who consumed soy foods monthly, 1–3 days/week, and ≥4 days/week, respectively. For cause-specific cardiovascular mortality, significant inverse associations were observed for coronary heart disease and acute myocardial infarction. Higher soy food consumption was associated with a lower risk of cardiovascular death, especially death from coronary heart disease and acute myocardial infarction, in Chinese adults with diabetes.

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Exercise cardiac power and the risk of coronary heart disease and cardiovascular mortality in men

Annals of Medicine ◽

10.1080/07853890.2016.1202444 ◽

2016 ◽

Vol 48 (8) ◽

pp. 625-630 ◽

Cited By ~ 1

Author(s):

Sudhir Kurl ◽

Timo Mäkikallio ◽

Sae Young Jae ◽

Kimmo Ronkainen ◽

Jari A. Laukkanen

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Mortality ◽

Cardiac Power

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Investigation of the Adherence to Prescribed Treatment of the Patients with Coronary Heart Disease

Ukraïnsʹkij žurnal medicini bìologìï ta sportu ◽

10.26693/jmbs06.05.263 ◽

2021 ◽

Vol 6 (5) ◽

pp. 263-269

Author(s):

V. O. Shuper ◽

◽

S. V. Shuper ◽

I. V. Trefanenko ◽

G. I. Shumko ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Secondary Prevention ◽

Cardiovascular Mortality ◽

Healthcare Professionals ◽

Complete Information ◽

Cardiovascular Death ◽

Medical Risk ◽

Medical Risk Factors

The purpose of the study was to investigate the adherence to secondary prevention medications among patients with coronary heart disease and identify factors associated with it. Materials and methods. We examined 40 patients diagnosed with coronary heart disease of more than 50 years old, who were prescribed with optimal medication for 1 year during hospitalization. Patients` adherence was defined according to MMS-8 Morisky values for secondary prevention medications prescribed by doctors. Also, questionnaires about individual reasons of non-compliance and for individual patient`s opinion about importance and usefulness of knowledge according to risk factors of the increase of cardiovascular mortality were designed and proposed to the patients. Simple descriptive statistics were used to elucidate the characteristics of the patient population and results from individual adherence tools. Final score was analyzed and correlation between patients’ data and level of adherence to prescribed treatment were identified. A correlation matrix (using Spearman’s coefficient) was reviewed for any evidence of collinearity. Results and discussion. Our study demonstrated higher level of non-adherence with secondary prevention medications in patients with coronary heart disease (60.0%). This fact can be explained by the socioeconomic reasons, less informative strategies from the medical staff to the patients. Severe regress of adherence was demonstrated after discharge from the hospital due to subjective improvement of the patients` condition with absence of supervision by out-patient specialists. Demographic characteristics of the patients suggested that some non-modified factors can affect compliance with the prescribed treatment. Better adherence was demonstrated by female married patients with higher educational level, with family history about cardiovascular death. Also, too much prescribed medications with difficult regime of usage with non-adequate out-patient supervision may significantly decrease adherence causing development of complications which may lead to re-hospitalizations and cardiovascular death. Our investigation demonstrated also non-complete information of the patients about lifestyle and medical risk factors of the cardiovascular mortality increase. Conclusion. The results of our study can provide useful practical information on the prevalence and severity of non-adherence among patients with coronary heart disease. Analysis of the factors influencing the adherence demonstrated the main reasons from patients and healthcare professionals affecting the level of compliance with the prescribed treatment. The step towards improving adherence can be initiated by the healthcare professional to overcome the patient's concerns about the prescribed medication. It is important to continue personal monitoring of patients by healthcare professionals in the form of regular inspections of intentional and unintentional non-adherence, including factors and reasons that may change and lead to such behavior

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High fish consumption was associated with a lower 30-year risk of death from coronary heart disease

Evidence-based Cardiovascular Medicine ◽

10.1016/s1361-2611(97)80053-x ◽

1997 ◽

Vol 1 (3) ◽

pp. 65

Author(s):

Lawrence Friedman

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Fish Consumption ◽

Risk Of Death ◽

High Fish

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Residual risk of cardiovascular mortality in patients with coronary heart disease: The EUROASPIRE Risk Categories

International Journal of Cardiology ◽

10.1016/j.ijcard.2012.10.051 ◽

2013 ◽

Vol 168 (2) ◽

pp. 910-914 ◽

Cited By ~ 17

Author(s):

Dirk De Bacquer ◽

Jean Dallongeville ◽

Kornelia Kotseva ◽

Marie Therese Cooney ◽

Andrzej Pajak ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Cardiovascular Mortality ◽

Residual Risk ◽

Risk Categories

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Longitudinal associations between marine omega-3 supplement users and coronary heart disease in a UK population-based cohort

BMJ Open ◽

10.1136/bmjopen-2017-017471 ◽

2017 ◽

Vol 7 (10) ◽

pp. e017471 ◽

Cited By ~ 5

Author(s):

Marleen A H Lentjes ◽

Ruth H Keogh ◽

Ailsa A Welch ◽

Angela A Mulligan ◽

Robert N Luben ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

General Population ◽

Fish Consumption ◽

Cox Regression ◽

Secondary Outcome ◽

Omega 3 ◽

Supplement Use ◽

Pufa Supplement ◽

Lower Hazard

ObjectivesAssess the association between marine omega-3 polyunsaturated fatty acid (n-3 PUFA) intake from supplements, mainly cod liver oil, and coronary heart disease (CHD) mortality.DesignProspective cohort study, with three exposure measurements over 22 years.SettingNorfolk-based European Prospective Investigation into Cancer (EPIC-Norfolk, UK).Participants22 035 men and women from the general population, 39–79 years at recruitment.ExposureSupplement use was assessed in three questionnaires (1993–1998; 2002–2004; 2004–2011). Participants were grouped into non-supplement users (NSU), n-3 PUFA supplement users (SU+n3) and non–n-3 PUFA supplement users (SU-n3). Cox regression adjusted for time-point specific variables: age, smoking, prevalent illnesses, body mass index, alcohol consumption, physical activity and season and baseline assessments of sex, social class, education and dietary intake (7-day diet diary).Primary and secondary outcome measuresDuring a median of 19-year follow-up, 1562 CHD deaths were registered for 22 035 included participants.ResultsBaseline supplement use was not associated with CHD mortality, but baseline food and supplement intake of n-3 PUFA was inversely associated with CHD mortality after adjustment for fish consumption. Using time-varying covariate analysis, significant associations were observed for SU+n3 (HR: 0.74, 95% CI 0.66 to 0.84), but not for SU-n3 versus NSU. In further analyses, the association for SU+n3 persisted in those who did not take other supplements (HR: 0.83, 95% CI 0.71 to 0.97). Those who became SU+n3 over time or were consistent SU+n3 versus consistent NSU had a lower hazard of CHD mortality; no association with CHD was observed in those who stopped using n-3 PUFA-containing supplements.ConclusionsRecent use of n-3 PUFA supplements was associated with a lower hazard of CHD mortality in this general population with low fish consumption. Residual confounding cannot be excluded, but the findings observed may be explained by postulated biological mechanisms and the results were specific to SU+n3.

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