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: 8300146
• 负责人: LUC DJOUSSE
• 金额: $ 36.45万
• 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/8300146
• 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

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 proposal 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 proposal highly cost-efficient.

心力衰竭（HF）是美国老年人住院的主要原因， 年发病率为55万例。尽管医学和外科治疗取得了进步， HF发作后的死亡率仍然很高。鉴于美国老年人的数量不断增加， 必须防止这种情况的发生。这需要创新的研究， 提供具有成本效益的干预工具，以改善HF的管理和预防。本 最后，饮食中摄入长链欧米茄-3（n-3）脂肪酸已被证明可以降低 心肌梗死和高血压-HF的两个主要危险因素。此外，n-3脂肪酸 已显示可减弱由压力超负荷引起的心室重塑和功能障碍 在动物模型中。目前流行病学证据支持n-3脂肪酸的这种有益作用 来自心血管健康研究，其中自我报告的鱼类消费量是 与老年人HF风险较低相关。然而，没有关于n-3影响的数据 脂肪酸对HF亚型（收缩期与舒张期HF）或HF病因（例如：缺血性与非缺血性）的影响 缺血性HF）。同样地，不清楚其它脂肪酸如反式脂肪酸（已知为 增加冠心病的风险）或蔬菜中富含的短链脂肪酸 (and比鱼便宜）可以预防HF的发生。由于没有研究报告审查 n-3脂肪酸补充剂与HF风险之间的关系，尚不清楚鱼中的n-3， 鱼中的营养物质，或与鱼类消费相关的生活方式因素， 观察鱼类摄入量对HF风险的影响。更重要的是，自我报告数据固有的偏见可能 导致错误的结论。目前的建议将不会受到这种限制，因为它将 检查血浆磷脂n-3脂肪酸（长链和短链， 链）和反式脂肪酸和HF在美国男性医生中使用可重复的方法， 测量脂肪酸摄入量。此外，我们还将评估血浆磷脂n-3 脂肪酸和HF亚型以及HF病因。这项研究的结果将有助于确定： n-3脂肪酸在HF的发展中是否重要，B）告知科学界， 设计饮食和/或补充剂对HF风险的潜在未来临床试验，以及c）帮助 确定可与其他措施一起沿着用于预防HF饮食因素。关于transs 脂肪可以提供额外的证据来支持反式脂肪酸使用的立法行动。 受试者招募、样本采集、关键协变量信息和 混淆因素等已被母研究涵盖，使得该提案具有高度的成本效益。