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Fish consumption and stroke risk in elderly individuals: the cardiovascular health study.
Arch Intern Med 2005; 165(2):200-6AI

Abstract

BACKGROUND

Associations between fish consumption and stroke risk have been inconsistent, possibly because of the differences in types of fish meals consumed. Additionally, such relationships have not been specifically evaluated in the elderly, in whom disease burden may be high and diet less influential.

METHODS

Among 4775 adults 65 years or older (range, 65-98 years) and free of known cerebrovascular disease at baseline in 1989-1990, usual dietary intake was assessed using a food frequency questionnaire. In a subset, consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches (fish burgers), correlated with plasma phospholipid long-chain n-3 fatty acid levels. Incident strokes were prospectively ascertained.

RESULTS

During 12 years of follow-up, participants experienced 626 incident strokes, including 529 ischemic strokes. In multivariate analyses, tuna/other fish consumption was inversely associated with total stroke (P = .04) and ischemic stroke (P = .02), with 27% lower risk of ischemic stroke with an intake of 1 to 4 times per week (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.98) and 30% lower risk with intake of 5 or more times per week (HR, 0.70; 95% CI, 0.50-0.99) compared with an intake of less than once per month. In contrast, fried fish/fish sandwich consumption was positively associated with total stroke (P = .006) and ischemic stroke (P = .003), with a 44% higher risk of ischemic stroke with consumption of more than once per week (HR, 1.44; 95% CI, 1.12-1.85) compared with consumption of less than once per month. Fish consumption was not associated with hemorrhagic stroke.

CONCLUSIONS

Among elderly individuals, consumption of tuna or other broiled or baked fish is associated with lower risk of ischemic stroke, while intake of fried fish or fish sandwiches is associated with higher risk. These results suggest that fish consumption may influence stroke risk late in life; potential mechanisms and alternate explanations warrant further study.

Authors+Show Affiliations

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard School of Public Health, Boston, MA, USA. dmozaffa@hsph.harvard.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15668367

Citation

Mozaffarian, Dariush, et al. "Fish Consumption and Stroke Risk in Elderly Individuals: the Cardiovascular Health Study." Archives of Internal Medicine, vol. 165, no. 2, 2005, pp. 200-6.
Mozaffarian D, Longstreth WT, Lemaitre RN, et al. Fish consumption and stroke risk in elderly individuals: the cardiovascular health study. Arch Intern Med. 2005;165(2):200-6.
Mozaffarian, D., Longstreth, W. T., Lemaitre, R. N., Manolio, T. A., Kuller, L. H., Burke, G. L., & Siscovick, D. S. (2005). Fish consumption and stroke risk in elderly individuals: the cardiovascular health study. Archives of Internal Medicine, 165(2), pp. 200-6.
Mozaffarian D, et al. Fish Consumption and Stroke Risk in Elderly Individuals: the Cardiovascular Health Study. Arch Intern Med. 2005 Jan 24;165(2):200-6. PubMed PMID: 15668367.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fish consumption and stroke risk in elderly individuals: the cardiovascular health study. AU - Mozaffarian,Dariush, AU - Longstreth,W T,Jr AU - Lemaitre,Rozenn N, AU - Manolio,Teri A, AU - Kuller,Lewis H, AU - Burke,Gregory L, AU - Siscovick,David S, PY - 2005/1/26/pubmed PY - 2005/2/18/medline PY - 2005/1/26/entrez SP - 200 EP - 6 JF - Archives of internal medicine JO - Arch. Intern. Med. VL - 165 IS - 2 N2 - BACKGROUND: Associations between fish consumption and stroke risk have been inconsistent, possibly because of the differences in types of fish meals consumed. Additionally, such relationships have not been specifically evaluated in the elderly, in whom disease burden may be high and diet less influential. METHODS: Among 4775 adults 65 years or older (range, 65-98 years) and free of known cerebrovascular disease at baseline in 1989-1990, usual dietary intake was assessed using a food frequency questionnaire. In a subset, consumption of tuna or other broiled or baked fish, but not fried fish or fish sandwiches (fish burgers), correlated with plasma phospholipid long-chain n-3 fatty acid levels. Incident strokes were prospectively ascertained. RESULTS: During 12 years of follow-up, participants experienced 626 incident strokes, including 529 ischemic strokes. In multivariate analyses, tuna/other fish consumption was inversely associated with total stroke (P = .04) and ischemic stroke (P = .02), with 27% lower risk of ischemic stroke with an intake of 1 to 4 times per week (hazard ratio [HR], 0.73; 95% confidence interval [CI], 0.55-0.98) and 30% lower risk with intake of 5 or more times per week (HR, 0.70; 95% CI, 0.50-0.99) compared with an intake of less than once per month. In contrast, fried fish/fish sandwich consumption was positively associated with total stroke (P = .006) and ischemic stroke (P = .003), with a 44% higher risk of ischemic stroke with consumption of more than once per week (HR, 1.44; 95% CI, 1.12-1.85) compared with consumption of less than once per month. Fish consumption was not associated with hemorrhagic stroke. CONCLUSIONS: Among elderly individuals, consumption of tuna or other broiled or baked fish is associated with lower risk of ischemic stroke, while intake of fried fish or fish sandwiches is associated with higher risk. These results suggest that fish consumption may influence stroke risk late in life; potential mechanisms and alternate explanations warrant further study. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15668367/Fish_consumption_and_stroke_risk_in_elderly_individuals:_the_cardiovascular_health_study_ L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.165.2.200 DB - PRIME DP - Unbound Medicine ER -