Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies.
Stroke 2023 ; 55: 50-58.
O'Keefe JH, Tintle NL, Harris WS, O'Keefe EL, Sala-Vila A, Attia J, Garg GM, Hure A, Bork CS, Schmidt EB, Venø SK, Chien KL, Chen YA, Egert S, Feldreich TR, Ärnlöv J, Lind L, Forouhi NG, Geleijnse JM, Pertiwi K, Imamura F, de Mello Laaksonen V, Uusitupa WM, Tuomilehto J, Laakso M, Lankinen MA, Laurin D, Carmichael PH, Lindsay J, Leander K, Laguzzi F, Swenson BR, Longstreth WT, Manson JE, Mora S, Cook NR, Marklund M, Melo van Lent D, Murphy R, Gudnason V, Ninomiya T, Hirakawa Y, Qian F, Sun Q, Hu F, Ardisson Korat AV, Riserus U, Lázaro I, Samieri C, Le Goff M, Helmer C, Steur M, Voortman T, Ikram MK, Tanaka T, Das JK, Ferrucci L, Bandinelli S, Tsai M, Guan W, Garg P, Verschuren WMM, Boer JMA, Biokstra A, Virtanen J, Wagner M, Westra J, Albuisson L, Yamagishi K, Siscovick DS, Lemaitre RN, Mozaffarian D
DOI : 10.1161/STROKEAHA.123.044281
PubMed ID : 38134264
PMCID :
URL : https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.044281
Abstract
The effect of marine omega-3 PUFAs on risk of stroke remains unclear.
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 prespecified analytical protocol with defined exposures, covariates, analytical methods, and outcomes; the harmonized data from the studies were then centrally pooled. Multivariable-adjusted HRs and 95% CIs across omega-3 PUFA quintiles were computed for each stroke outcome.
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, comparing quintile 5 (Q5, highest) with quintile 1 (Q1, lowest), total stroke incidence was 17% lower (HR, 0.83 [CI, 0.76-0.91]; <0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74-0.91]; <0.0001). For docosahexaenoic acid, comparing Q5 with Q1, there was a 12% lower incidence of total stroke (HR, 0.88 [CI, 0.81-0.96]; =0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78-0.95]; =0.0001). Neither eicosapentaenoic acid nor docosahexaenoic acid was associated with a risk for hemorrhagic stroke. These associations were not modified by either baseline history of AF or prevalent CVD.
Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.