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(Circulation. 2005;112:3232-3238.)
© 2005 American Heart Association, Inc.

Arrhythmia/Electrophysiology

Dietary -Linolenic Acid Intake and Risk of Sudden Cardiac Death and Coronary Heart Disease

Christine M. Albert, MD; Kyungwon Oh, PhD; William Whang, MD; JoAnn E. Manson, MD; Claudia U. Chae, MD; Meir J. Stampfer, MD; Walter C. Willett, MD; Frank B. Hu, MD

From the Center for Arrhythmia Prevention (C.M.A.), Division of Preventive Medicine (C.M.A., C.U.C., J.E.M., M.J.S.), Cardiovascular Division (C.M.A.) and the Channing Laboratory (M.J.S., J.E.M., W.C.W., F.B.H.), Department of Medicine, Brigham and Women’s Hospital; the Cardiology Division (C.M.A., W.W., C.U.C), Department of Medicine, Massachusetts General Hospital; and the Departments of Epidemiology (M.J.S., J.E.M., W.C.W., F.B.H) and Nutrition (K.O., M.J.S., W.C.W.), Harvard School of Public Health, Boston, Mass.

Reprint requests to Dr Christine Albert, Division of Preventive Medicine, Brigham and Women’s Hospital, 900 Commonwealth Ave E, Boston, MA 02215-1204. E-mail calbert{at}partners.org

Received June 27, 2005; revision received August 12, 2005; accepted August 19, 2005.

Background— -Linolenic acid, an intermediate-chain n-3 fatty acid found primarily in plants, may decrease the risk of fatal coronary heart disease (CHD) through a reduction in fatal ventricular arrhythmias and sudden cardiac death (SCD).

Methods and Results— We prospectively examined the association between dietary intake of -linolenic acid assessed via updated food-frequency questionnaires and the risk of SCD, other fatal CHD, and nonfatal myocardial infarction (MI) among 76 763 women participating in the Nurses’ Health Study who were free from cancer and completed a dietary questionnaire at baseline in 1984. During 18 years of follow-up, we identified 206 SCDs, 641 other CHD deaths, and 1604 nonfatal MIs. After controlling for coronary risk factors and other fatty acids, including long-chain n-3 fatty acids, the intake of -linolenic acid was inversely associated with the risk of SCD (P for trend, 0.02) but not with the risk of other fatal CHD or nonfatal MI. Compared with women in the lowest quintile of -linolenic acid intake, those in the highest 2 quintiles had a 38% to 40% lower SCD risk. This inverse relation with SCD risk was linear and remained significant even among women with high intakes of long-chain n-3 fatty acids.

Conclusions— These prospective data suggest that increasing dietary intake of -linolenic acid may reduce the risk of SCD but not other types of fatal CHD or nonfatal MI in women. The specificity of the association between -linolenic acid and SCD supports the hypothesis that these n-3 fatty acids may have antiarrhythmic properties.

Key Words: death, sudden • women • arrhythmia • nutrition • fatty acids

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