N-3 polyunsaturated fatty acids from fish and cardiovascular disease

J. de Goede, J.M. Geleijnse, L.M. Oude Griep, D. Kromhout, W.M.M. Verschuren

Research output: Contribution to journalArticleAcademic


N-3 polyunsaturated fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are associated with a reduced risk of fatal coronary heart disease (CHD) and cardiovascular disease (CVD). We examined these associations in a general Dutch population. Design: Between 1993–1997, participants filled out questionnaires on diet and lifestyle. We included 20,148 subjects, 20–59y, with no history of myocardial infarction or stroke. Hazard Ratios (HRs) were calculated with Cox proportional-hazard models, adjusted for age, gender, BMI, family history of CVD, supplement use, cholesterol lowering or anti-hypertensive drugs, education level, smoking, and intake of alcohol, energy, fruit, vegetables, and saturated fat. Endpoints were classified by the International Classification of Diseases. Results: Median intakes in quartiles of EPAþDHA were 39, 84, 150, and 233mg/day. During 8–13y of follow-up, 607 patients died of which 155 of CVD and 82 of CHD. The adjusted HR for fatal CHD was lower in the highest quartile of EPAþDHA (0.53; 95% CI: 0.28–0.99) as compared with the lowest quartile. For fatal CVD, this was not found (Q4: 0.85; 95% CI: 0.54–1.33). The number of incident cases was 1157 for CVD and 752 for CHD. HRs for incident CVD across quartiles of EPAþDHA intake compared with the lowest quartile were: 1.01 (0.85–1.20), 1.07 (0.90–1.27), 0.97 (0.82–1.15). For incident CHD HRs were: 0.90 (0.72–1.11), 1.06 (0.86–1.30), and 0.97 (0.79–1.19). Conclusion: Dietary EPAþDHA is associated with fatal CHD, even in a population with a low fish intake. We found no associations of EPAþDHA with non-fatal CHD and with fatal and non-fatal CVD
Original languageEnglish
Pages (from-to)S21-S21
JournalEuropean Journal of Clinical Nutrition
Issue numberS3
Publication statusPublished - 2009


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