High long-chain n-3 fatty acid intake attenuates the effect of high resting heart rate on cardiovascular mortality risk: a 24-year follow-up of Japanese general population

Takashi Hisamatsu; Katsuyuki Miura; Takayoshi Ohkubo; Takashi Yamamoto; Akira Fujiyoshi; Naoko Miyagawa; Aya Kadota; Naoyuki Takashima; Nagako Okuda; Katsushi Yoshita; Yoshikuni Kita; Yoshitaka Murakami; Yasuyuki Nakamura; Tomonori Okamura; Minoru Horie; Akira Okayama; Hirotsugu Ueshima; NIPPON DATA80 Research Group

doi:10.1016/j.jjcc.2014.01.005

High long-chain n-3 fatty acid intake attenuates the effect of high resting heart rate on cardiovascular mortality risk: a 24-year follow-up of Japanese general population

J Cardiol. 2014 Sep;64(3):218-24. doi: 10.1016/j.jjcc.2014.01.005. Epub 2014 Feb 11.

Authors

Takashi Hisamatsu¹, Katsuyuki Miura², Takayoshi Ohkubo³, Takashi Yamamoto⁴, Akira Fujiyoshi⁵, Naoko Miyagawa⁵, Aya Kadota⁶, Naoyuki Takashima⁵, Nagako Okuda⁷, Katsushi Yoshita⁸, Yoshikuni Kita⁵, Yoshitaka Murakami⁹, Yasuyuki Nakamura¹⁰, Tomonori Okamura¹¹, Minoru Horie⁴, Akira Okayama¹², Hirotsugu Ueshima²; NIPPON DATA80 Research Group

Collaborators

Affiliations

¹ Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan; Department of Health Science, Shiga University of Medical Science, Otsu, Japan; Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan. Electronic address: hisataka@belle.shiga-med.ac.jp.
² Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan; Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
³ Department of Health Science, Shiga University of Medical Science, Otsu, Japan; Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
⁴ Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
⁵ Department of Health Science, Shiga University of Medical Science, Otsu, Japan.
⁶ Department of School Nursing and Health Education, Osaka Kyoiku University, Osaka, Japan.
⁷ Section of Shokuiku, Department of Nutritional Education, National Institute of Health and Nutrition, Tokyo, Japan.
⁸ Department of Food Science and Nutrition, Osaka City University, Osaka, Japan.
⁹ Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan; Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan.
¹⁰ Cardiovascular Epidemiology, Kyoto Women's University, Kyoto, Japan.
¹¹ Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan.
¹² First Institute for Health Promotion and Health Care, Tokyo, Japan.

PMID: 24529505
DOI: 10.1016/j.jjcc.2014.01.005

Abstract

Background: Increased resting heart rate (RHR) independently predicts cardiovascular mortality. Meanwhile, long-chain n-3 fatty acids (LCn3FAs) have a cardioprotective effect. Our aim was to evaluate whether higher LCn3FAs intake attenuates the elevated risk of cardiovascular mortality associated with increased RHR.

Methods: We conducted a population-based 24-year prospective cohort study of Japanese, whose LCn3FAs intake is relatively high. Study participants included 8807 individuals aged 30-95 years from randomly selected areas across Japan without cardiovascular diseases and anti-hypertensive drugs at baseline. The primary endpoint was cardiovascular mortality, and the secondary endpoints were cardiac and stroke mortality during 24 years of follow-up. Individual dietary LCn3FAs intake was estimated from household-based 3-day weighed food records. RHR was obtained from 3 consecutive R-wave intervals on 12-lead electrocardiography. Cox models were used to estimate the multivariable hazard ratios (HRs) and 95% confidence intervals (95% CIs) adjusting for possible confounders.

Results: During the follow-up period, 617 cardiovascular deaths were observed. The median daily intake of LCn3FAs was 0.37% kcal (0.86g/day). The interaction between dietary LCn3FAs intake and RHR in the risk of cardiovascular mortality was statistically significant (p=0.033). The risk of cardiovascular mortality was significantly higher in the low-intake group (<0.37%kcal) with an RHR >85beats/min (bpm) [hazard ratio (HR), 1.67; 95% confidence interval (CI), 1.15-2.43], but not in the high-intake group (≥0.37%kcal) with an RHR >85bpm (HR, 0.92; 95% CI, 0.61-1.38), compared with those in the high-intake group with an RHR <70bpm. Similar results were observed with stroke mortality, but not with cardiac mortality.

Conclusions: The risk of cardiovascular mortality associated with increased RHR is elevated in participants with low dietary LCn3FAs intake, but not in participants with high dietary LCn3FAs intake in a representative Japanese general population. These results suggest that high dietary LCn3FAs intake may prevent cardiovascular mortality associated with increased RHR.

Keywords: Cardiovascular disease; Electrocardiography; Fatty acids; Heart rate; Prevention.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Aged
Aged, 80 and over
Asian People
Cardiotonic Agents / administration & dosage*
Cardiotonic Agents / pharmacology*
Cardiovascular Diseases / mortality*
Cardiovascular Diseases / physiopathology
Cardiovascular Diseases / prevention & control*
Cohort Studies
Dietary Fats, Unsaturated / administration & dosage*
Dietary Fats, Unsaturated / pharmacology*
Fatty Acids, Omega-3 / administration & dosage*
Fatty Acids, Omega-3 / pharmacology*
Female
Follow-Up Studies
Forecasting
Heart Rate / drug effects*
Humans
Male
Middle Aged
Prospective Studies
Risk
Time Factors

Substances

Cardiotonic Agents
Dietary Fats, Unsaturated
Fatty Acids, Omega-3