Fatty Acids and Heart Failure in the Physicians' Health Study

医生健康研究中的脂肪酸和心力衰竭

• 批准号: 8088157
• 负责人: LUC DJOUSSE
• 金额: $ 60.08万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-15 至 2014-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8088157
• 关键词: Address; Animal Model; Atherosclerosis; Atrial Fibrillation; Attenuated; C-reactive protein; Cardiovascular system; Cessation of life; Clinical; Clinical Trials; Communities; Comorbidity; Consumption; Coronary Arteriosclerosis; Coronary heart disease; Data; Development; Diastolic heart failure; Diet; Dietary Factors; Dietary Fatty Acid; Dietary Intervention; Dietary Supplementation; Dietary intake; Elderly; Epidemiologic Studies; Epidemiology; Etiology; Fatty Acids; Fishes; Flax; Food; Frequencies; Future; Guidelines; Health; Heart failure; Hospitalization; Hypertension; Incidence; Inflammatory; Intake; Juglans; Lead; Left Ventricular Function; Life Style; Lipids; Measurement; Measures; Mediating; Medical; Methods; Myocardial Infarction; Myocardial Ischemia; Nutrient; Obesity; Omega-3 Fatty Acids; Operative Surgical Procedures; Parents; Pathway interactions; Patient Self-Report; Phospholipids; Physicians; Plant Sources; Plants; Plasma; Play; Population; Prevention; Prevention strategy; Public Health; Publishing; Questionnaires; Reporting; Research; Risk; Risk Factors; Role; Sample Size; Seafood; Source; Specimen; Systolic heart failure; Testing; Trans Fats; Trans Fatty Acids; Vegetables; Ventricular Dysfunction; Ventricular Remodeling; Volatile Fatty Acids; base; cohort; community setting; cost; cost effective; design; effective intervention; follow-up; improved; innovation; lifestyle factors; male; mortality; nutrition; pressure; prevent; sample collection; tool

DESCRIPTION (provided by applicant): Heart failure (HF) is the leading cause of hospitalization among elderly people in the US with an annual incidence rate of 550,000 cases. Despite advances in medical and surgical treatment, mortality after the onset of HF remains high. Given the growing number of older adults in the US, it is imperative to prevent the occurrence of this condition. This calls for innovative research that could provide cost-effective intervention tools to improve the management and prevention of HF. To this end, dietary intake of long-chain omega-3 (n-3) fatty acids has been shown to lower the risk of myocardial infarction and hypertension - two major risk factors for HF. In addition, n-3 fatty acids have been shown to attenuate ventricular remodeling and dysfunction induced by pressure overload in animal models. Current epidemiologic evidence to support such beneficial effect of n-3 fatty acids on HF comes from the Cardiovascular Health Study in which self-reported fish consumption was associated with a lower risk of HF in older adults. However, no data are available on the effects of n-3 fatty acids on HF subtypes (systolic vs. diastolic HF) or HF etiology (for example: ischemic vs. non-ischemic HF). Likewise, it is not clear whether other fatty acids such as trans fatty acids (known to increase the risk of coronary heart disease) or short-chain fatty acids found abundantly in vegetables (and cheaper than fish) could prevent the occurrence of HF. In the absence of a study examining the relation between n-3 fatty acid supplements and risk of HF, it is unclear whether n-3 in fish, other nutrients in fish, or lifestyle factors associated with fish consumption were responsible for the observed effects of fish intake on HF risk. More importantly, bias inherent to self-reported data might lead to erroneous conclusions. The current application will not suffer from such limitations as it will examine the association between plasma phospholipid n-3 fatty acids (both long-chain and short- chain) and trans fatty acids and HF among US male physicians using a reproducible method to measure fatty acid intake. Furthermore, we will assess the relation between plasma phospholipid n-3 fatty acids and HF subtypes as well as HF etiology. Findings of this study will a) help determine whether n-3 fatty acids are important in the development of HF, b) inform the scientific community in designing potential future clinical trials of diet and/or supplements on the risk of HF, and c) help identify dietary factors that could be use along with other measures to prevent HF. Results on trans fats may provide additional evidence to support legislative action on the usage of trans fatty acids. The fact that the costs for subject recruitment, sample collection, information on key covariates and confounders, etc, have been covered by the parent study makes this application highly cost-efficient. PUBLIC HEALTH RELEVANCE: As the leading cause of hospitalization among elderly people in the US, heart failure is still a major public health issue. Little is known about the role of dietary fatty acids on the risk of heart failure. If the current project identifies dietary factors that influence the risk of heart failure, then such information could help reshape dietary guidelines as a major component of prevention strategies designed to lower the risk of heart failure in the population.

描述（申请人提供）：心力衰竭 (HF) 是美国老年人住院的主要原因，年发病率为 550,000 例。尽管医学和外科治疗取得了进步，心力衰竭发作后的死亡率仍然很高。鉴于美国老年人数量不断增加，必须防止这种情况的发生。这就需要创新研究来提供具有成本效益的干预工具，以改善心力衰竭的管理和预防。为此，饮食中摄入长链 omega-3 (n-3) 脂肪酸已被证明可以降低心肌梗塞和高血压（心力衰竭的两个主要危险因素）的风险。此外，n-3 脂肪酸已被证明可以减轻动物模型中压力超负荷引起的心室重塑和功能障碍。当前支持 n-3 脂肪酸对心力衰竭有益作用的流行病学证据来自心血管健康研究，其中自我报告的鱼类消费与老年人心力衰竭风险较低相关。然而，尚无 n-3 脂肪酸对心力衰竭亚型（收缩性心力衰竭与舒张性心力衰竭）或心力衰竭病因（例如：缺血性心力衰竭与非缺血性心力衰竭）影响的数据。同样，尚不清楚其他脂肪酸，如反式脂肪酸（已知会增加冠心病的风险）或蔬菜中含量丰富的短链脂肪酸（比鱼便宜）是否可以预防心力衰竭的发生。由于缺乏研究 n-3 脂肪酸补充剂与心力衰竭风险之间关系的研究，尚不清楚鱼中的 n-3、鱼中的其他营养素或与鱼类消费相关的生活方式因素是否是观察到的鱼类摄入对心力衰竭风险影响的原因。更重要的是，自我报告数据固有的偏见可能会导致错误的结论。当前的应用程序不会受到此类限制，因为它将使用可重复的方法测量脂肪酸摄入量，检查美国男性医生血浆磷脂 n-3 脂肪酸（长链和短链）和反式脂肪酸与心力衰竭之间的关联。此外，我们将评估血浆磷脂 n-3 脂肪酸与 HF 亚型以及 HF 病因学之间的关系。这项研究的结果将 a) 帮助确定 n-3 脂肪酸在心力衰竭的发生中是否重要，b) 为科学界设计未来潜在的关于心力衰竭风险的饮食和/或补充剂的临床试验提供信息，以及 c) 帮助确定可与其他预防心力衰竭措施一起使用的饮食因素。反式脂肪的结果可能会提供额外的证据来支持针对反式脂肪酸的使用采取立法行动。事实上，受试者招募、样本收集、关键协变量和混杂因素信息等的成本已由母研究承担，使得该应用程序具有很高的成本效益。公共卫生相关性：作为美国老年人住院的主要原因，心力衰竭仍然是一个主要的公共卫生问题。关于膳食脂肪酸对心力衰竭风险的作用知之甚少。如果当前的项目确定了影响心力衰竭风险的饮食因素，那么这些信息可以帮助重塑饮食指南，将其作为旨在降低人群心力衰竭风险的预防策略的主要组成部分。