European Heart Journal Advance Access originally published online on April 21, 2009
European Heart Journal 2009 30(12):1495-1500; doi:10.1093/eurheartj/ehp111
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Fish consumption, marine omega-3 fatty acids, and incidence of heart failure: a population-based prospective study of middle-aged and elderly men
1 Cardiovascular Epidemiology Research Unit, Beth Israel Deaconess Medical Center, Harvard Medical School, 375 Longwood Avenue, MS-443, Boston, MA 02215, USA
2 Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
Received 30 June 2008; revised 26 February 2009; accepted 4 March 2009; online publish-ahead-of-print 21 April 2009.
* Corresponding author. Tel: +1 617 632 7705, Fax: +1 617 632 7698, Email: elevitan{at}bidmc.harvard.edu
Aims: Fatty fish and marine omega-3 fatty acids were associated with lower rates of heart failure (HF) among US elderly, but this has not been confirmed in broader age ranges or other populations where source and type of fish may differ. We therefore conducted a population-based, prospective study of 39 367 middle-aged and older Swedish men.
Methods and results: Diet was measured using food-frequency questionnaires. Men were followed for HF through Swedish inpatient and cause-of-death registers from 1 January 1998 to 31 December 2004. We used proportional hazards models adjusted for age and other covariates to estimate hazard ratios (HR). Compared with no consumption, men who ate fatty fish once per week had an HR of 0.88 (95% CI 0.68–1.13). Hazard ratios for consumption two times per week and 
3 times per week were 0.99 and 0.97, respectively. Hazard ratios across quintiles of marine omega-3 were 1, 0.94 (95% CI 0.74–1.20), 0.67 (95% CI 0.50–0.90), 0.89 (95% CI 0.68–1.16), 1.00 (95% CI 0.77–1.29).
Conclusion: In this population, moderate intake of fatty fish and marine omega-3 fatty acids was associated with lower rates of HF, though the association for fish intake was not statistically significant; higher intake was not associated with additional benefit.
Key Words: Heart failure • Diet • Omega-3 fatty acids • Fish
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