Authors
Daviglus ML. Stamler J. Orencia AJ. Dyer AR. Liu K. Greenland P. Walsh
MK. Morris D. Shekelle RB.
Institution
Department of Preventive Medicine, Northwestern University Medical School,
Chicago, IL 60611, USA.
Title
Fish consumption and the 30-year risk of fatal myocardial infarction [see
comments].
Comments
Comment in: N Engl J Med 1997 Aug 14;337(7):497-8; discussion 498-9, Comment
in: N Engl J Med 1997 Aug 14;337(7):498; discussion 498-9, Comment in: N Engl
J Med 1997 Aug 14;337(7);498-9, Comment in: ACP J Club 1997 Nov-Dec;127(3):80
Source
New England Journal of Medicine. 336(15):1046-53, 1997 Apr 10.
Abstract
BACKGROUND: Epidemiologic data on the possible benefit of eating fish to
reduce the risk of coronary heart disease have been
inconsistent. We used data from the Chicago Western Electric Study to examine
the relation between base-line fish consumption and the 30-year risk of death
from coronary heart disease. METHODS: The study participants
were 1822 men who were 40 to 55 years old and free of
cardiovascular disease at base line. Fish
consumption, as determined from a detailed dietary history, was stratified
(0, 1 to 17, 18 to 34, and > or = 35 g per day). Mortality from coronary
heart disease, ascertained from death certificates, was
classified as death from myocardial infarction (sudden or nonsudden) or death
from other coronary causes. RESULTS: During 47,153 person-years of follow-up,
there were 430 deaths from coronary heart disease; 293 were
due to myocardial infarctions (196 were sudden, 94 were nonsudden, and 3 were
not classifiable). Cox proportional-hazards regression showed that for men
who consumed 35 g or more of fish daily as compared with those who consumed
none, the relative risks of death from coronary heart
disease and from sudden or nonsudden myocardial infarction
were 0.62 (95 percent confidence interval, 0.40 to 0.94) and 0.56 (95 percent
confidence interval, 0.33 to 0.93), respectively, with a graded relation
between the relative risks and the strata of fish consumption (P for trend =
0.04 and 0.02, respectively). These findings were accounted for by the
relation of fish consumption to nonsudden death from myocardial infarction
(relative risk, 0.33; 95 percent confidence interval, 0.12 to 0.91; P for
trend= 0.007). CONCLUSIONS: These data show an inverse association between
fish consumption and death from coronary heart disease,
especially nonsudden death from myocardial infarction.