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Omega-3 Blood Levels and Stroke Risk: A Pooled and Harmonized Analysis of 183 291 Participants From 29 Prospective Studies
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2024 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 55, no 1, p. 50-58Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

The effect of marine omega-3 PUFAs on risk of stroke remains unclear.

METHODS:

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.

RESULTS:

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]; P<0.0001), and ischemic stroke was 18% lower (HR, 0.82 [CI, 0.74–0.91]; P<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]; P=0.0001) and a 14% lower incidence of ischemic stroke (HR, 0.86 [CI, 0.78–0.95]; P=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.

CONCLUSIONS:

Higher omega-3 PUFA levels are associated with lower risks of total and ischemic stroke but have no association with hemorrhagic stroke.

Place, publisher, year, edition, pages
American Heart Association , 2024. Vol. 55, no 1, p. 50-58
Keywords [en]
atrial fibrillation, cerebrovascular disease, fish, fish oil, stroke
National Category
Public Health, Global Health, Social Medicine and Epidemiology Neurology
Identifiers
URN: urn:nbn:se:uu:diva-520257DOI: 10.1161/STROKEAHA.123.044281ISI: 001128650000001PubMedID: 38134264OAI: oai:DiVA.org:uu-520257DiVA, id: diva2:1826627
Funder
NIH (National Institutes of Health), T32HL110837Available from: 2024-01-11 Created: 2024-01-11 Last updated: 2024-03-15Bibliographically approved

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Lind, LarsMarklund, MattiRisérus, Ulf

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