Abstract P038: Associations of Plasma Phospholipid and Dietary Alpha Linolenic Acid with Mortality, Coronary Heart Disease and Stroke in Older Adults: The Cardiovascular Health Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Amanda M Fretts ◽  
Dariush Mozaffarian ◽  
David Siscovick ◽  
Colleen Sitlani ◽  
Bruce M Psaty ◽  
...  
Keyword(s):  
Older Adults ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Plasma Phospholipid ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Analysis Group ◽  
Cvd Mortality

Objective: To examine the association of α-linolenic acid (ALA 18:3n-3), an essential n-3 fatty acid derived from plants and vegetable oils, with mortality, coronary heart disease, and stroke among older adults. Due to the low correlation between dietary and circulating ALA that may reflect differences in diet and metabolism, we evaluated plasma phospholipid ALA and dietary ALA separately. Methods: The study population included participants from the Cardiovascular Health Study, a community-based longitudinal cohort of adults aged 65 or older, free of prevalent coronary heart disease and stroke. A total of 2,709 participants comprised the plasma phospholipid analysis group and 4,214 participants comprised the dietary analysis group. Plasma phospholipid ALA, an objective measure of circulating levels of ALA over the past 4-8 weeks, was measured using stored samples from 1992-1993. Dietary fatty acid intake was ascertained using food frequency questionnaires administered in 1989 and 1996. ALA was expressed as percent of total fatty acids and percent of total dietary fat for the plasma phospholipid and dietary analyses, respectively. Cox regression was used to assess the associations of plasma phospholipid and dietary ALA with mortality, and incident coronary heart disease or stroke. Results: Dietary ALA and plasma phospholipid ALA were modestly correlated (r=0.18). We found no statistically significant associations of plasma phospholipid ALA with mortality, incident CHD or stroke (table). After adjustment for potential confounders, dietary intake of ALA was associated with a lower risk of total and non-CVD mortality. We found no statistically significant associations of dietary ALA with CVD mortality, incident CHD or stroke (table). Conclusions: Results from this prospective cohort study of older adults suggest that dietary, but not plasma phospholipid ALA, is associated with a lower risk of total and non-CVD mortality in older adults.

scholarly journals Plasma phospholipid and dietary α-linolenic acid, mortality, CHD and stroke: the Cardiovascular Health Study

2014 ◽  
Vol 112 (7) ◽  
pp. 1206-1213 ◽  
Author(s):  
Amanda M. Fretts ◽  
Dariush Mozaffarian ◽  
David S. Siscovick ◽  
Colleen Sitlani ◽  
Bruce M. Psaty ◽  
...  
Keyword(s):  
Older Adults ◽  
Linolenic Acid ◽  
Cardiovascular Mortality ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Plasma Phospholipid ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Risk Of Mortality ◽  
Long Chain

Previous studies have suggested that long-chain n-3 fatty acids derived from seafood are associated with a lower risk of mortality, CHD and stroke. Whether α-linolenic acid (ALA, 18 : 3n-3), a plant-derived long-chain essential n-3 fatty acid, is associated with a lower risk of these outcomes is unclear. The aim of the present study was to examine the associations of plasma phospholipid and dietary ALA with the risk of mortality, CHD and stroke among older adults who participated in the Cardiovascular Health Study, a cohort study of adults aged ≥ 65 years. A total of 2709 participants were included in the plasma phospholipid ALA analysis and 2583 participants were included in the dietary ALA analysis. Cox regression was used to assess the associations of plasma phospholipid and dietary ALA with the risk of mortality, incident CHD and stroke. In minimally and multivariable-adjusted models, plasma phospholipid ALA was found to be not associated with the risk of mortality, incident CHD or stroke. After adjustment for age, sex, race, enrolment site, education, smoking status, diabetes, BMI, alcohol consumption, treated hypertension and total energy intake, higher dietary ALA intake was found to be associated with a lower risk of total and non-cardiovascular mortality; on comparing the highest quintiles of dietary ALA with the lowest quintiles, the HR for total mortality and non-cardiovascular mortality were found to be 0·73 (95 % CI 0·61, 0·88) and 0·64 (95 % CI 0·52, 0·80), respectively. Dietary ALA was found to be not associated with the risk of cardiovascular mortality, incident CHD or stroke. In conclusion, the results of the present suggest study that dietary ALA, but not plasma phospholipid ALA, is associated with a lower risk of total and non-cardiovascular mortality in older adults.

Alcohol Consumption and Risk of Coronary Heart Disease in Older Adults: The Cardiovascular Health Study

2006 ◽  
Vol 54 (1) ◽  
pp. 30-37 ◽  
Author(s):  
Kenneth J. Mukamal ◽  
Hyoju Chung ◽  
Nancy S. Jenny ◽  
Lewis H. Kuller ◽  
W.T. Longstreth ◽  
...  
Keyword(s):  
Older Adults ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Alcohol Consumption ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study

scholarly journals The −50G>T Polymorphism in the Promoter of the CYP2J2 Gene in Coronary Heart Disease: The Ludwigshafen Risk and Cardiovascular Health Study

2007 ◽  
Vol 53 (3) ◽  
pp. 539-540 ◽  
Author(s):  
Michael M Hoffmann ◽  
Peter Bugert ◽  
Ursula Seelhorst ◽  
Britta Wellnitz ◽  
Bernhard R Winkelmann ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study

Abstract P145: Circulating and Dietary Trans-Fatty Acids and Incident Type-2 Diabetes Mellitus in Older Adults: The Cardiovascular Health Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Qianyi Wang ◽  
Fumiaki Imamura ◽  
Wenjie Ma ◽  
Rozenn N Lemaitre ◽  
Irena B King ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Older Adults ◽  
Fatty Acids ◽  
Trans Fatty Acids ◽  
Cardiovascular Health ◽  
Plasma Phospholipid ◽  
Health Study ◽  
Cardiovascular Health Study

Background: While trans-fatty acids (TFA) influence CHD, their effects on type 2 diabetes mellitus (DM) are not established, with mixed findings of experimental, short-term intervention, and observational studies. Effects may vary depending on specific TFA subtype or method of assessment (circulating biomarkers vs. diet). Objectives: To examine prospective associations of circulating and estimated dietary TFA with risk of incident DM in older adults. Methods: Plasma phospholipid trans-(t-)16:1n9, total t-18:1, and cis/trans-(c/t-), t/c- and t/t-18:2(n6,9) were measured in blood stored among 3,076 adults in the Cardiovascular Health Study (CHS), aged 74±5y and free of prevalent DM in 1992. Dietary TFA was estimated among 4,246 adults free of prevalent DM when dietary questionnaires were initially administered in 1989 (n=3,917) or in 1996 (n=329). Incident DM up to 2009 was defined as new use of insulin or hypoglycemic drugs, fasting glucose≥126 mg/dL, nonfasting glucose≥200 mg/dL, or 2-hour post-challenge glucose≥200 mg/dL. The relative risk of incident DM associated with each TFA subtype was assessed using multivariate Cox proportional hazards regression. Results: Levels of each circulating TFA subtype varied from 2.00±0.73 (% of fatty acids) for t-18:1 to 0.05±0.02 for t/t-18:2. TFA subtypes were moderately to highly intercorrelated (r=0.4 to 0.8), except for t/t-18:2 which weakly correlated with all other TFAs (r<0.1). During 30,927 person-years, 364 DM cases occurred among participants with plasma phospholipid TFA measures. Adjusting for demographics, lifestyle factors, and medical history, lower DM risk was associated with higher levels of t-16:1n9 (Quartile 4 vs. Quartile 1 HR=0.76, p trend=0.03), total t-18:1 (HR=0.71, p trend=0.02) and t/t-18:2 (HR=0.73, p trend=0.04). However, further mutual adjustment for the different TFA subtypes attenuated these inverse associations, and none of the 5 circulating TFA biomarkers were independently related to incident DM (p trend≥0.14 for all). During 50,508 person-years in the dietary analyses, 453 DM cases occurred. Adjusting for demographics, lifestyle, medical history, and other dietary habits, increased DM risk was observed among participants with higher consumption of total TFA (Quartile 4 vs. Quartile 1 HR=1.40, p trend=0.04) and t-18:2 (HR=1.49, p trend=0.006), and t-18:1 consumption (HR=1.32, p trend=0.08), although the latter was not statistically significant. Conclusions: Plasma phospholipid TFA subtypes were not associated, whereas dietary total TFA and t-18:2 were positively associated, with incident DM among older adults. These findings highlight the need to understand how dietary TFA may influence DM and why associations may differ for circulating versus dietary TFAs.

Abstract 056: Associations of Total and High-Molecular-Weight Adiponectin with All-Cause and Cardiovascular Mortality in Older Persons: The Cardiovascular Health Study (CHS)

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jorge R Kizer ◽  
David Benkeser ◽  
Alice M Arnold ◽  
Kenneth J Mukamal ◽  
Joachim H Ix ◽  
...  
Keyword(s):  
Older Adults ◽  
Molecular Weight ◽  
High Molecular Weight ◽  
Cardiovascular Health ◽  
Additive Model ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
High Molecular Weight Adiponectin ◽  
Risk Of Death ◽  
Cvd Mortality

Background: Adiponectin (APN) is inversely related to incident cardiovascular disease (CVD) in healthy middle-aged cohorts, but the opposite has been observed among older populations or those with prevalent CVD, where higher APN imparts greater risk of CVD and death. Emerging data suggest, however, that the association of total APN with mortality in elders may be U-shaped. Methods: We tested the hypotheses that both total and high-molecular-weight (HMW) APN (r=0.94) manifest different relations with mortality in subgroups of older adults defined by the presence or absence of prior CVD or heart failure (HF)/atrial fibrillation (AF). Specifically, we hypothesized that total and HMW APN would show similar U-shaped associations with all-cause and CVD death in subjects without prevalent CVD or HF/AF (Group [Gp] 1; n= 3272), but would exhibit positive monotonic associations with these outcomes in subgroups with prevalent CVD but no HF/AF (Gp 2; n=1030), and with prevalent HF/AF (Gp 3; n=383). We addressed these questions in CHS, a population-based US cohort aged 65 and older, of whom 4715 had available samples since 1992–93. Associations were examined with general additive model plots, and modeled with linear splines. Results: During 16 years of follow-up, 1947 all-cause and 634 CVD deaths occurred in Gp 1, 802 and 375 in Gp 2, and 337 and 180 in Gp 3. There was evidence of effect modification by subgroup status for both outcomes (p≤0.034), with total and HMW APN showing significant departures from linearity in their relations with all-cause and CVD mortality in Gp 1 (p≤0.043), but not Gps 2 or 3. The association between total APN and all-cause mortality was U-shaped, such that after adjustment for potential confounders, increasing levels up to 12.4 mg/L (median) were associated with a lower risk of death (HR 0.81 per SD [0.65–0.95]), but above this cutpoint, higher levels imparted a higher risk (HR 1.19 per SD [1.12–1.27]). Further adjustment for putative mediators (glucose, lipids, inflammation) abolished the association in the lower range, but left that in the upper range unaffected. The relationship was largely similar for HMW adiponectin. No significant association between total or HMW APN with mortality was apparent in Gp 2. In Gp 3, both total and HMW APN showed positive adjusted associations with mortality across their distributions, which were magnified after inclusion of putative mediators (HRs 1.31 [1.15–1.50] and 1.36 [1.20–1.55], respectively). Results were comparable for CVD mortality in all Gps. Conclusions: These findings show that total and HMW APN bear similar associations with all-cause and CVD mortality in older adults, and that these differ according to prevalent CVD or HF/AF status. These observations provide a potential explanation for the APN paradox, underscoring the need to better characterize the underpinnings of the hormone’s beneficial and harmful associations.

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