Table 3.
Associations of Circulating EPA+DHA in Quintiles With CHD, CVD, and All‐Cause Mortality in the Alpha Omega Cohort
| Circulating EPA+DHA | P trend* | |||||
|---|---|---|---|---|---|---|
| Q1 | Q2 | Q3 | Q4 | Q5 | ||
| ≤1.29 (n=818) | >1.29 to 1.56 (n=809) | >1.56 to 1.92 (n=813) | >1.92 to 2.52 (n=812) | >2.52 (n=815) | ||
| Median circulating EPA+DHA, % total FAs | 1.12 | 1.43 | 1.73 | 2.17 | 3.14 | |
| Person‐years | 8890 | 8904 | 8966 | 9152 | 9318 | |
| CHD mortality | ||||||
| Cases, n | 123 | 99 | 107 | 89 | 97 | |
| Age‐ and sex‐adjusted HR | 1.00 (reference) | 0.85 (0.65–1.11) | 0.89 (0.69–1.15) | 0.72 (0.55–0.95) | 0.75 (0.58–0.98) | 0.031 |
| Multivariable HR † | 1.00 (reference) | 0.83 (0.63–1.09) | 0.88 (0.67–1.16) | 0.72 (0.54–0.96) | 0.71 (0.53–0.94) | 0.020 |
| CVD mortality | ||||||
| Cases, n | 183 | 160 | 175 | 159 | 157 | |
| Age‐ and sex‐adjusted HR | 1.00 (reference) | 0.92 (0.74–1.14) | 0.96 (0.78–1.18) | 0.86 (0.70–1.06) | 0.80 (0.65–0.99) | 0.032 |
| Multivariable HR | 1.00 (reference) | 0.90 (0.72–1.11) | 0.94 (0.75–1.15) | 0.85 (0.68–1.07) | 0.75 (0.60–0.95) | 0.016 |
| All‐cause mortality | ||||||
| Cases, n | 420 | 388 | 370 | 359 | 340 | |
| Age‐ and sex‐adjusted HR | 1.00 (reference) | 0.97 (0.85–1.12) | 0.89 (0.77–1.02) | 0.85 (0.74–0.98) | 0.76 (0.66–0.88) | <0.001 |
| Multivariable HR | 1.00 (reference) | 0.97 (0.84–1.12) | 0.90 (0.77–1.04) | 0.86 (0.74–1.00) | 0.73 (0.63–0.86) | <0.001 |
CHD indicates coronary heart disease; CVD, cardiovascular disease; DHA, docosahexaenoic acid; EPA, eicosapentaenoic acid; FA, fatty acid; HR, hazard ratio; and Q1 to Q5, quintile 1 to quintile 5. Values in Table represent hazard ratios (HRs) with 95% CIs, estimated from multivariable Cox models.
P for linear trend, through median values across categories of circulating eicosapentaenoic acid+ docosahexaenoic acid, using a linear regression model.
HRs were adjusted for age, sex, education level, physical activity, smoking status, alcohol intake, obesity, prevalent diabetes, cardiovascular drugs, serum cholesterol, circulating linoleic acid (18:2 n‐6), and circulating arachidonic acid (20:4 n‐6).