Evidence map›Paper›PMID 25124495›Full record

ArticleCirculation2014

Circulating omega-6 polyunsaturated fatty acids and total and cause-specific mortality: the Cardiovascular Health Study.

Jason H Y Wu, Rozenn N Lemaitre, Irena B King, Xiaoling Song, Bruce M Psaty, David S Siscovick, Dariush Mozaffarian

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 11 pooled it
14.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

102 citing papers in PubMed, 11 syntheses or guidelines pooled it, 198 citations in OpenAlex.

  1. Pooled it
  2. Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Pooled it
  8. Pooled it
  9. Metabolic profiling of alcohol consumption in 9778 young adults.International journal of epidemiology · 2016
    Pooled it
  10. Pooled it
  11. Pooled it
  12. Trial
  13. Trial
  14. Trial
  15. Trial
  16. Trial
  17. Trial
  18. Trial
  19. Trial
  20. Trial

42 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Jason H Y WuFrom The George Institute for Global Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (J.H.Y.W.); Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle (R.N.L., B.M.P.); the Department of Internal Medicine, University of New Mexico, Albuquerque (I.B.K.); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (X.S.); the Department of Epidemiology and Health Service, University of Washington, Seattle (B.M.P.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); New York Academy of Medicine, New York (D.S.S.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.). jwu1@georgeinstitute.org.au.
Rozenn N LemaitreFrom The George Institute for Global Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (J.H.Y.W.); Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle (R.N.L., B.M.P.); the Department of Internal Medicine, University of New Mexico, Albuquerque (I.B.K.); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (X.S.); the Department of Epidemiology and Health Service, University of Washington, Seattle (B.M.P.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); New York Academy of Medicine, New York (D.S.S.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
Irena B KingFrom The George Institute for Global Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (J.H.Y.W.); Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle (R.N.L., B.M.P.); the Department of Internal Medicine, University of New Mexico, Albuquerque (I.B.K.); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (X.S.); the Department of Epidemiology and Health Service, University of Washington, Seattle (B.M.P.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); New York Academy of Medicine, New York (D.S.S.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
Xiaoling SongFrom The George Institute for Global Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (J.H.Y.W.); Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle (R.N.L., B.M.P.); the Department of Internal Medicine, University of New Mexico, Albuquerque (I.B.K.); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (X.S.); the Department of Epidemiology and Health Service, University of Washington, Seattle (B.M.P.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); New York Academy of Medicine, New York (D.S.S.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
Bruce M PsatyFrom The George Institute for Global Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (J.H.Y.W.); Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle (R.N.L., B.M.P.); the Department of Internal Medicine, University of New Mexico, Albuquerque (I.B.K.); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (X.S.); the Department of Epidemiology and Health Service, University of Washington, Seattle (B.M.P.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); New York Academy of Medicine, New York (D.S.S.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
David S SiscovickFrom The George Institute for Global Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (J.H.Y.W.); Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle (R.N.L., B.M.P.); the Department of Internal Medicine, University of New Mexico, Albuquerque (I.B.K.); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (X.S.); the Department of Epidemiology and Health Service, University of Washington, Seattle (B.M.P.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); New York Academy of Medicine, New York (D.S.S.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
Dariush MozaffarianFrom The George Institute for Global Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (J.H.Y.W.); Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle (R.N.L., B.M.P.); the Department of Internal Medicine, University of New Mexico, Albuquerque (I.B.K.); Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA (X.S.); the Department of Epidemiology and Health Service, University of Washington, Seattle (B.M.P.); Group Health Research Institute, Group Health Cooperative, Seattle, WA (B.M.P.); New York Academy of Medicine, New York (D.S.S.); and Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA (D.M.).
Fred Hutch Cancer Center · USUniversity of Washington · USKaiser Permanente Washington Health Research Institute · USTufts University · USUniversity of New Mexico · US

Funding

Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R01AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2004 to 2016
$9.5M
CHS Events Follow-up StudyR01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2009 to 2014
$6.3M
Fatty Acids and Major Cardiovascular OutcomesR01HL085710 · NHLBI · TUFTS UNIVERSITY BOSTON · PI MOZAFFARIAN, DARIUSH · 2006 to 2016
$5.1M
CHS Events Follow-up StudyU01HL080295 · NHLBI · UNIVERSITY OF WASHINGTON · PI PSATY, BRUCE M · 2005 to 2008
$4.6M
Role of EIIIA fibronectin in pulmonary fibrosisR01HL085083 · NHLBI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI WHITE, ERIC S · 2007 to 2011
$1.9M
Exceptional Survival: Trajectories to Functional Aging (CHS All Stars)R56AG023629 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI NEWMAN, ANNE B. · 2010 to 2010
$300k
CHS-Transition Phase -268055222-268055222N01HC055222 · HC · UNIVERSITY OF WASHINGTON · PI KRONMAL, RICHARD A · 2005 to 2006
–
CENTRAL BLOOD ANALYSIS LABORATORY FOR CHSN01HC085086 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1988 to 2000
–
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65 TO 84N01HC085079 · HC · UNIVERSITY OF WASHINGTON · 1988 to 2005
–
CORONARY HEART DISEASE &STROKE IN THE ELDERLYN01HC085080 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1988 to 2000
–
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085081 · HC · JOHNS HOPKINS UNIVERSITY · PI FRIED, LINDA P · 1988 to 2000
–
CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84N01HC085082 · HC · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KULLER, LEWIS H · 1988 to 2000
–
NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS HL080295NHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS R01 HL080295NHLBI NIH HHS R01 HL085710NHLBI NIH HHS U01 HL080295NIA NIH HHS AG023629NIA NIH HHS R01 AG023629NIA NIH HHS R56 AG023629
6 · The paper itself

Abstract

backgroundAlthough omega-6 polyunsaturated fatty acids (n-6 PUFA) have been recommended to reduce coronary heart disease (CHD), controversy remains about benefits versus harms, including concerns over theorized proinflammatory effects of n-6 PUFA. We investigated associations of circulating n-6 PUFA including linoleic acid (the major dietary PUFA), γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid, with total and cause-specific mortality in the Cardiovascular Health Study, a community-based U.S. cohort. METHODS AND

resultsAmong 2792 participants(aged ≥65 years) free of cardiovascular disease at baseline, plasma phospholipid n-6 PUFA were measured at baseline using standardized methods. All-cause and cause-specific mortality, and total incident CHD and stroke, were assessed and adjudicated centrally. Associations of PUFA with risk were assessed by Cox regression. During 34 291 person-years of follow-up (1992-2010), 1994 deaths occurred (678 cardiovascular deaths), with 427 fatal and 418 nonfatal CHD, and 154 fatal and 399 nonfatal strokes. In multivariable models, higher linoleic acid was associated with lower total mortality, with extreme-quintile hazard ratio =0.87 (P trend=0.005). Lower death was largely attributable to cardiovascular disease causes, especially nonarrhythmic CHD mortality (hazard ratio, 0.51; 95% confidence interval, 0.32-0.82; P trend=0.001). Circulating γ-linolenic acid, dihomo-γ-linolenic acid, and arachidonic acid were not significantly associated with total or cause-specific mortality (eg, for arachidonic acid and CHD death, the extreme-quintile hazard ratio was 0.97; 95% confidence interval, 0.70-1.34; P trend=0.87). Evaluated semiparametrically, linoleic acid showed graded inverse associations with total mortality (P=0.005). There was little evidence that associations of n-6 PUFA with total mortality varied by age, sex, race, or plasma n-3 PUFA. Evaluating both n-6 and n-3 PUFA, lowest risk was evident with highest levels of both.

conclusionsHigh circulating linoleic acid, but not other n-6 PUFA, was inversely associated with total and CHD mortality in older adults.

Indexed as

AgedArachidonic AcidBiomarkersCohort StudiesCoronary DiseaseFatty Acids, Omega-3Fatty Acids, Omega-6Fatty Acids, UnsaturatedFemaleFollow-Up StudiesHumansLinoleic AcidMaleProspective StudiesRegression AnalysisRisk FactorsArachidonic AcidBiomarkersFatty Acids, Omega-3Fatty Acids, Omega-6Fatty Acids, UnsaturatedLinoleic Acidcardiovascular diseasesepidemiologyfatty acids, omega-6mortality

Identifiers

PMID25124495
PMCPMC4189990
OpenAlexW2136604885

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.