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

基本信息

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
项目类别：
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

项目摘要

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（由申请人提供）：心力衰竭（HF）是美国老年人住院的主要原因，其年发病率为550,000例。尽管医学和手术治疗方面取得了进步，但HF发作后的死亡率仍然很高。鉴于在美国的老年人数量越来越多，必须防止这种情况发生。这呼吁进行创新的研究，可以提供具有成本效益的干预工具来改善HF的管理和预防。为此，长链omega-3（N-3）脂肪酸的饮食摄入已显示出降低心肌梗塞和高血压的风险 - HF的两个主要风险因素。另外，已经证明N-3脂肪酸可以减弱动物模型中压力超负荷引起的心室重塑和功能障碍。当前的流行病学证据支持N-3脂肪酸对HF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耗与老年人的HF风险较低有关。但是，尚无有关N-3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HF）的影响的数据。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）还是在蔬菜中大量发现（比鱼类便宜）发现的短链脂肪酸是否可以防止发生HF。在没有研究N-3脂肪酸补充剂与HF风险之间的关系的研究中，尚不清楚鱼类中的N-3，鱼类中的其他营养物质或与鱼类消耗相关的生活方式因素是导致鱼类摄入量对HF风险的影响的原因。更重要的是，自我报告的数据固有的偏差可能会导致错误的结论。当前的应用不会受到限制，因为它将使用可再现的方法来测量脂肪酸摄入的方法，检查血浆磷脂N-3脂肪酸（长链和短链）和反式脂肪酸和HF之间的关联。此外，我们将评估血浆磷脂N-3脂肪酸和HF亚型的关系以及HF病因。这项研究的结果将a）帮助确定N-3脂肪酸在HF的发展中是否重要，b）为科学界的饮食和/或补充剂设计潜在的临床试验而告知科学界有关HF风险的临床试验，c）有助于识别可以与其他措施一起使用的饮食因素，以防止HF。反式脂肪的结果可能会提供其他证据，以支持对反式脂肪酸使用的立法行动。父母研究涵盖了该应用程序的成本高效，这一事实是，有关招聘的成本，样本收集，有关关键协变量和混杂因素的信息以及混杂因素等的信息。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。关于饮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，这是旨在降低人群心力衰竭风险的预防策略的主要组成部分。