Abstract
Background: Numerous prospective studies suggest inverse associations between intake of polyunsaturated fatty acids (PUFA) and cardiovascular outcomes. However, recent randomized studies have failed to demonstrate these benefits. One of the prevailing hypotheses is that the beneficial effects of PUFA may now be masked by the widespread use of statins, which lower lipids and blood pressure and are potent modulators of cardiovascular risk. Hypothesis: We tested the hypothesis that the association between PUFA and hypertension varies by statin use. Methods and Results: We conducted a cross-sectional analysis based on 74,658 black and white men and women in the Southern Community Cohort Study. Intake of PUFA was assessed by a food-frequency questionnaire, while history of diagnosed hypertension and statin use were self-reported. The mean±SD age was 52±9 years, body mass index was 30±8 kg/m 2 , and energy intake from PUFA was 8.0±1.8%. Sixty percent of the participants were women and 68% were African Americans. Hypertension (55%), statin use (16%), smoking (40%) and alcohol use (55%) were common in this cohort. In an adjusted logistic model with hypertension as the dependent variable, there was no interaction between PUFA intake and statin therapy ( P =0.13), whereas a significant inverse association was evident between PUFA intake and hypertension among non-statin users ( P for trend = 0.03) but not among statin users ( P for trend = 0.36) ( Table ). Conclusion: In conclusion, these results support a beneficial effect of PUFA consumption on hypertension, which is only apparent in the absence of statin therapy. These findings underscore the need to stratify by statin therapy when randomizing participants to cardiovascular interventions and support the notion that PUFA may be important in cardiovascular risk reduction in patients where statin therapy is not an option.
Published Version
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