TABLE 4.
CVD incidence HRs and 95% CIs for a doubling of fatty acids densities, with and without biomarker calibrations of FFQ assessments in Women’s Health Initiative cohorts (n = 81,894) of postmenopausal United States women enrolled during 1993–1998 at 40 United States clinical centers and followed through December 20201
| No additional baseline FFQ measures |
Additional baseline FFQ measures2 |
|||||||
|---|---|---|---|---|---|---|---|---|
| With biomarker calibration |
Without biomarker calibration |
With biomarker calibration |
Without biomarker calibration |
|||||
| Outcome (participants with events) | HR (95% CI)3 | P value | HR (95% CI) | P value | HR (95% CI) | P value | HR (95% CI) | P value |
| Nonfatal MI (2102) | ||||||||
| SFA density | 1.11 (1.03, 1.19) | 0.005 | 1.16 (1.04, 1.30) | 0.01 | 1.01 (0.92, 1.11) | 0.82 | 1.04 (0.91, 1.18) | 0.59 |
| PUFA density | 1.05 (1.01, 1.10) | 0.02 | 0.98 (0.88, 1.09) | 0.76 | 0.99 (0.94, 1.05) | 0.83 | 0.94 (0.84, 1.06) | 0.32 |
| Coronary death (897) | ||||||||
| SFA density | 1.13 (1.02, 1.26) | 0.02 | 1.25 (1.06, 1.48) | 0.009 | 1.11 (0.96, 1.28) | 0.15 | 1.18 (0.96, 1.44) | 0.11 |
| PUFA density | 1.04 (0.98, 1.11) | 0.19 | 0.89 (0.75, 1.04) | 0.15 | 1.05 (0.96, 1.15) | 0.29 | 0.96 (0.81, 1.15) | 0.66 |
| Total CHD (2869) | ||||||||
| SFA density | 1.10 (1.04, 1.17) | 0.001 | 1.18 (1.07, 1.29) | <0.001 | 1.04 (0.96, 1.12) | 0.35 | 1.07 (0.96, 1.20) | 0.22 |
| PUFA density | 1.04 (1.01, 1.08) | 0.02 | 0.95 (0.87, 1.04) | 0.25 | 1.01 (0.96, 1.06) | 0.71 | 0.95 (0.86, 1.05) | 0.32 |
| Ischemic stroke (1776) | ||||||||
| SFA density | 1.09 (1.01, 1.18) | 0.02 | 1.13 (1.01, 1.28) | 0.04 | 1.04 (0.94, 1.15) | 0.42 | 1.06 (0.92, 1.23) | 0.40 |
| PUFA density | 1.05 (1.00, 1.10) | 0.03 | 1.01 (0.90, 1.13) | 0.91 | 1.02 (0.96, 1.09) | 0.54 | 0.99 (0.87, 1.12) | 0.83 |
| Hemorrhagic stroke (395) | ||||||||
| SFA density | 1.02 (0.89, 1.17) | 0.79 | 1.05 (0.82, 1.34) | 0.71 | 0.98 (0.81, 1.18) | 0.84 | 1.01 (0.75, 1.36) | 0.96 |
| PUFA density | 1.00 (0.92, 1.08) | 0.96 | 0.94 (0.74, 1.20) | 0.63 | 0.97 (0.86, 1.09) | 0.58 | 0.89 (0.68, 1.17) | 0.41 |
| Total stroke (2425) | ||||||||
| SFA density | 1.08 (1.01, 1.15) | 0.02 | 1.12 (1.01, 1.24) | 0.03 | 1.02 (0.94, 1.11) | 0.62 | 1.05 (0.92, 1.18) | 0.48 |
| PUFA density | 1.04 (1.00, 1.08) | 0.06 | 0.99 (0.89, 1.09) | 0.78 | 1.00 (0.95, 1.06) | 0.94 | 0.95 (0.86, 1.07) | 0.41 |
| CHD + stroke (5023) | ||||||||
| SFA density | 1.09 (1.04, 1.14) | <0.001 | 1.14 (1.06, 1.22) | <0.001 | 1.03 (0.97, 1.09) | 0.39 | 1.05 (0.97, 1.14) | 0.25 |
| PUFA density | 1.04 (1.01, 1.07) | 0.004 | 0.97 (0.91, 1.04) | 0.45 | 1.01 (0.97, 1.04) | 0.78 | 0.96 (0.89, 1.03) | 0.28 |
| CABG + PCI (3119) | ||||||||
| SFA density | 1.02 (0.96, 1.08) | 0.55 | 0.99 (0.91, 1.09) | 0.91 | 0.97 (0.89, 1.04) | 0.36 | 0.94 (0.84, 1.05) | 0.25 |
| PUFA density | 1.03 (0.99, 1.06) | 0.11 | 1.09 (1.00, 1.19) | 0.05 | 0.99 (0.94, 1.04) | 0.66 | 1.04 (0.95, 1.15) | 0.40 |
| Total CVD4 (6964) | ||||||||
| SFA density | 1.06 (1.02, 1.10) | 0.002 | 1.09 (1.02, 1.16) | 0.006 | 1.00 (0.95, 1.05) | 0.89 | 1.01 (0.94, 1.09) | 0.78 |
| PUFA density | 1.03 (1.01, 1.06) | 0.004 | 1.01 (0.95, 1.07) | 0.82 | 1.00 (0.97, 1.03) | 0.92 | 0.98 (0.92, 1.05) | 0.59 |
| Heart failure (1381) | ||||||||
| SFA density | 1.12 (1.02, 1.22) | 0.02 | 1.19 (1.04, 1.36) | 0.01 | 1.07 (0.95, 1.2) | 0.25 | 1.12 (0.95, 1.32) | 0.16 |
| PUFA density | 1.05 (0.99, 1.11) | 0.08 | 0.95 (0.83, 1.08) | 0.44 | 1.03 (0.95, 1.10) | 0.48 | 0.95 (0.82, 1.10) | 0.48 |
Abbreviations: CABG/PCI, coronary artery bypass graft or percutaneous coronary intervention.
Covariates considered for inclusion are age (linear), BMI, season of FFQ completion, race/ethnicity, family income, education, cigarette smoking history, alcohol intake (drinks/wk), leisure physical activity (metabolic equivalent units/wk), any dietary supplement use, prior menopausal hormone use, antihypertension medication use, antidiabetic medication use, history of treated diabetes, history of treated hypertension, personal history of CVD, family history of MI, stroke, or diabetes.
Additional covariates in this model include log (total trans fatty acids (g)+1) vegetable servings/d, fruit servings/d, and log(total fiber(g)+1).
HR estimates and 95% CIs are based on Cox models with baseline hazard rates stratified on study component (DM-C or OS), hormone therapy trial status (estrogen plus progestin, estrogen plus progestin placebo, estrogen-alone, estrogen-alone placebo, not randomized), age at enrollment (50–54, 55–59, 60–64, 65–69, 70–74, ≥75), and race/ethnicity, and with adjustment for a disease-specific set of potential confounding factors listed above.
Total CVD comprised of CHD + CABG + PCI + stroke.