Fish intake and the risk of incident heart failure: the Women's Health Initiative.

BACKGROUND Whether fish or the fatty acids they contain are independently associated with risk for incident heart failure (HF) among postmenopausal women is unclear. METHODS AND RESULTS The baseline Women's Health Initiative Observational Study cohort consisted of 93 676 women ages 50 to 79 years of diverse ethnicity and background, of which 84 493 were eligible for analyses. Intakes of baked/broiled fish, fried fish, and omega-3 fatty acid (eicosapentaenoic acid+docosahexaenoic acid, α-linolenic acid), and trans-fatty acid were determined from the Women's Health Initiative food frequency questionnaire. Baked/broiled fish consumption was divided into 5 frequency categories: <1/mo (referent), 1 to 3/mo, 1 to 2/wk, 3 to 4/wk, ≥5/wk. Fried fish intake was grouped into 3 frequency categories: <1/mo (referent), 1-3/mo, and ≥1/wk. Associations between fish or fatty acid intake and incident HF were determined using Cox models adjusting for HF risk factors and dietary factors. Baked/broiled fish consumption (≥5 servings/wk at baseline) was associated with a hazard ratio of 0.70 (95% confidence interval, 0.51 to 0.95) for incident HF. In contrast, fried fish consumption (≥1 serving/wk at baseline) was associated with a hazard ratio of 1.48 (95% confidence interval, 1.19 to 1.84) for incident HF. No significant associations were found between eicosapentaenoic acid+docosahexaenoic acid, α-linolenic acid, or trans-fatty acid intake and incident HF. CONCLUSIONS Increased baked/broiled fish intake may lower HF risk, whereas increased fried fish intake may increase HF risk in postmenopausal women.