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ARS Home » Northeast Area » Boston, Massachusetts » Jean Mayer Human Nutrition Research Center On Aging » Research » Publications at this Location » Publication #410992
Research Project: Nutrition, Epidemiology, and Healthy Aging

Location: Jean Mayer Human Nutrition Research Center On Aging

Title: Omega-3 levels and stroke risk: a pooled and harmonized analysis of 183,291 participants from 29 prospective studies

Author
item O'KEEFE, JAMES - University Of Missouri
item TINTLE, NATHAN - Fatty Acid Research Institute
item HARRIS, WILLIAM - Fatty Acid Research Institute
item O'KEEF, EVAN - Tulane University
item SALA-VILA, ALEIX - Fatty Acid Research Institute
item ATTIA, JOHN - University Of Newcastle
item GARG, MANOHAR - University Of Newcastle
item BORK, CHRISTIAN - Aalborg University Hospital
item SCHMIDT, ERIK - Aalborg University Hospital
item VENOE, STINE - Aalborg University Hospital
item HURE, ALEXIS - University Of Newcastle
item CHIEN, KUO-LIONG - National Taiwan University
item EGERT, SARAH - University Of Bonn
item FELDREICH, TOBIAS - Dalarna University
item ARNLOV, JOHAN - Karolinska Institute
item LIND, LARS - Uppsala University
item FOROUHI, NITA - University Of Cambridge
item GELEIJNSE, JOHANNA - Wageningen University
item PERTIWI, KARMALITA - Wageningen University
item IMAMURA, FUMIAKI - University Of Cambridge
item LAAKSONEN, VANESSA - University Of Eastern Finland
item UUSITUPA, MATTI - University Of Eastern Finland
item TOUMILEHTO, JAAKKO - University For Continuing Education Krems
item LAAKSO, MARKKU - University Of Kuopio
item LANKINEN, MARIA - University Of Eastern Finland
item LAURIN, DANIELLE - Laval University
item CARMICHAEL, PIERRE-HUGUES - Vitam
item LINDSAY, JOAN - University Of Ottawa
item LEANDER, KARIN - Karolinska Institute
item LAGUZZI, FREDERICA - Karolinska Institute
item SWENSON, BRENTON - University Of Washington
item LONGSTRETH, JR., W.T. - University Of Washington
item MANSON, JOANN - Brigham & Women'S Hospital
item MORA, SAMIA - Harvard Medical School
item COOK, NANCY - Brigham & Women'S Hospital
item MARKLAND, MATTI - The George Institute For Global Health
item MELO VAN LENT, DEBORA - University Of Texas
item MURPHY, RACHEL - University Of British Columbia
item GUDNASON, VILMUNDUR - Icelandic Heart Association
item NINOMIYA, TOSHIHARU - Kyushu University
item HIRAKAWA, Y - Kyushu University
item QIAN, FRANK - Beth Israel Deaconess Medical Center
item SUN, QI - Brigham & Women'S Hospital
item HU, FRANK - Harvard School Of Public Health
item ARDISSON KORAT, ANDRES - Jean Mayer Human Nutrition Research Center On Aging At Tufts University
item RISERUS, ULF - Uppsala University
item LAZARA, IOLANDA - Hospital Del Mar Medical Research Institute
item SAMIERI, CECILIA - Bordeaux University
item LE GOFF, MELANIE - University Of Bordeaux
item HELMER, CATHERINE - Institut National De La Sante Et De La Recherche Medicale (INSERM)
item STEUR, MARINKA - University Medical Center Rotterdam
item VOORTMAN, TRUDY - Erasmus Medical Center
item KAMRAN IKRAM, M. - Erasmus Medical Center
item TANAKA, TOSHIKO - National Institute On Aging (NIA, NIH)
item DAS, JAYANTA - The Tata Institute Of Fundamental Research
item FERRUCCI, LUIGI - National Institute On Aging (NIA, NIH)
item TSAI, MICHAEL - University Of Minnesota
item GUAN, WEIHUA - University Of Minnesota
item GARG, PARVEEN - University Of Southern California
item VERSCHUREN, W.M. - National Institute For Public Health And The Environment (RIVM)
item BOER, JOLANDA - National Institute For Public Health And The Environment (RIVM)
item BLOKSTRA, ANNEKE - National Institute For Public Health And The Environment (RIVM)
item VIRTANEN, JYRKI - University Of Eastern Finland
item WAGNER, MICHAEL - University Hospital Zurich
item YAMAGISHI, KAZUMASA - University Of Tsukuba
item SISCOVICK, DAVID - New York Academy Of Medicine
item ROZENN, LAMAITRE - University Of Washington
item MOZAFFARIAN, DARIUSH - Tufts University

Submitted to: Stroke
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/30/2023
Publication Date: 1/1/2024
Citation: O'Keefe, J., Tintle, N., Harris, W., O'Keefe, E., Sala-Vila, A., Attia, J., Garg, M., Bork, C., Schmidt, E., Venoe, S., Hure, A., Chien, K., Egert, S., Feldreich, T., Arnlov, J., Lind, L., Forouhi, N.G., Geleijnse, J., Pertiwi, K., Imamura, F., Laaksonen, V., Uusitupa, M., Toumilehto, J., Laakso, M., Lankinen, M., Laurin, D., Carmichael, P., Lindsay, J., Leander, K., Laguzzi, F., Swenson, B., Longstreth, Jr., W., Manson, J., Mora, S., Cook, N., Markland, M., Melo Van Lent, D., Murphy, R., Gudnason, V., Ninomiya, T., Hirakawa, Y., Qian, F., Sun, Q., Hu, F., Ardisson Korat, A., Riserus, U., Lazara, I., Samieri, C., Le Goff, M., Helmer, C., Steur, M., Voortman, T., Kamran Ikram, M., Tanaka, T., Das, J., Ferrucci, L., Tsai, M., Guan, W., Garg, P., Verschuren, W.M., Boer, J., Blokstra, A., Virtanen, J., Wagner, M., Yamagishi, K., Siscovick, D., Rozenn, L., Mozaffarian, D. 2024. Omega-3 levels and stroke risk: a pooled and harmonized analysis of 183,291 participants from 29 prospective studies. Stroke. https://doi.org/10.1161/STROKEAHA.123.044281.
DOI: https://doi.org/10.1161/STROKEAHA.123.044281

Interpretive Summary: The role of omega-3 polyunsaturated fatty acid intake in the development of stroke remains unclear. We evaluated the relationship between circulating and tissue markers of omega-3 fatty acid levels and incident stroke in a global pooled analysis of 29 cohorts that included ~183,000 participants without history of stroke at study enrollment. Each participating study measured omega-3 fatty acid levels from blood samples or adipose tissue provided by participants at study enrollment. Our study found that higher biomarker levels of omega-3 levels are associated with lower risks of total and ischemic stroke, which suggest a potential benefit of omega-3 fatty acid intake in the prevention of stroke.

Technical Abstract: Background: The effect of marine omega-3 polyunsaturated fatty acids (PUFAs) on risk of stroke remains unclear. Methods: We investigated the associations between circulating and tissue omega-3 PUFA levels and incident stroke (total, ischemic, and hemorrhagic) in 29 international prospective cohorts. Each site conducted a de novo individual level analysis using a pre-specified analytical protocol with defined exposures, covariates, analytical methods and outcomes; the harmonized data from the 29 studies were then centrally pooled. Multivariable adjusted hazard ratios (HR) and 95% confidence intervals (CI) across omega-3 PUFA quintiles were computed for each stroke outcome. Results: Among 183,291 study participants, there were 10,561 total strokes, 8220 ischemic strokes and 1142 hemorrhagic strokes recorded over a median of 14.3 years follow-up. For eicosapentaenoic acid (EPA), comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (0.83, CI 0.76-0.91; P<0.0001), and ischemic stroke was 18% lower (0.82, CI 0.74-0.91; P<0.0001). For docosahexaenoic acid (DHA), comparing Q5 with Q1, there was a 12% lower incidence of total stroke (0.88, CI 0.82-0.94; P=0.0001) and a 14% lower incidence of ischemic stroke (0.86, CI 0.79-0.94; P=0.0001). Neither EPA nor DHA was associated with risk for hemorrhagic stroke. These associations were not modified by either baseline history of atrial fibrillation (AF) or prevalent cardiovascular (CV) disease (CVD). Conclusion: Higher omega-3 levels are associated with lower risks of total and ischemic stroke, but not with hemorrhagic stroke.