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How to Decrease Your Chances of Heart Failure

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Patient With IV DripCongestive heart failure is one of the leading causes of all hospitalizations among U.S. adults aged 65 years or older. Heart failure is a chronic condition (although it can develop suddenly) in which the heart is no longer able to pump enough blood to the rest of the body. This can cause blood to back up in the lungs, liver, gastrointestinal tract, and the arms and legs, which is known as congestive heart failure (CHF).

Coronary artery disease (narrowed arteries) is the most common cause of heart failure, and other risk factors include high blood pressure, high cholesterol, diabetes and/or obesity. Thankfully, these are conditions that can be headed off or helped through diet, exercise and supplements.

Studies suggest that seafood-derived long-chain omega-3 polyunsaturated fatty acids may reduce the risk for coronary heart disease, in particular coronary death.[1] But less is known about their effect on congestive heart failure, and according to the American Heart Association, while deaths related to coronary heart disease are decreasing in many countries, the incidence and costs of CHF are steadily increasing. So in a recent study, researchers set out to discover whether omega-3 fatty acids helped prevent CHF in older adults.[2]

In the past, research evaluating the connection between fatty acids and CHF has produced conflicting results, but it has typically been based on estimates from dietary questionnaires.  This new study differed in that researchers measured the circulating concentrations of omega-3 fatty acids in the subjects’ blood, which is a much more accurate reflection and takes into account biological processes, such as absorption, incorporation and metabolism. What’s more, this method allowed researchers to evaluate individual omega-3 fatty acids, specifically eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA) and docosahexaenoic acid (DHA).

For the study, researchers looked at 2,735 U.S. adults aged 65 years or older without prevalent heart disease who were enrolled in the Cardiovascular Health Study from 1992 to 2006. They examined the participants, asked about their dietary habits, and obtained blood samples to measure fatty acids. They followed up with annual study clinic examinations and interim phone calls to see whether CHF developed.

During this time, 555 cases of incident CHF occurred, and the cumulative incidence was 20.3 percent over 14 years, which highlights the high risk for developing CHF among people over the age of 65. That’s the bad news. The good news is that they found that people with higher concentrations of omega-3 fatty acids, especially EPA, were less likely to develop CHF.

After adjusting for demographic, cardiovascular and lifestyle risk factors, people with the highest concentrations of EPA had approximately 50 percent lower risk of CHF. (Interestingly, while DHA concentration had the strongest correlation with the amount of fish consumed, EPA concentration was most strongly associated with CHF.)

The findings seem to make a strong case for the role of omega-3 fatty acids in helping to prevent CHF, but the researchers point to some limitations of the study. The main one was that blood levels of fatty acids were only measured once, so it is possible that they changed significantly throughout the course of the study. Additionally, they admitted that they cannot say for certain whether the fatty acids or other unidentified factors were the cause of the good health effects that were observed.

However, the study results were enough for them to conclude: “Our findings demonstrate that long-chain omega-3 fatty acids, in particular EPA, are associated with lower risk for CHF in older adults. These observational results support existing recommendations that adults consume at least 2 servings per week of fish, especially oily fish.”

How to Get Those Fatty Acids

Fish high in omega-3 fatty acids include mackerel, tuna, salmon, sturgeon, mullet, bluefish, anchovy, sardines, herring, trout and menhaden. You can also take fish oil supplements; however, this research looked only at biomarkers of omega-3 fatty acids that were generally derived from seafood intake. The authors do say that the ranges of dietary omega-3 fatty acid exposure are generally much lower than would be seen for supplements. So one could reasonably assume that the higher concentration found in fish oil supplements may have even more protective benefits.

When all is said and done, it seems that it would be a good idea, especially if you are over the age of 65, to consume the recommended two servings of oily fish per week. You may also want to consider adding a fish oil supplement to your daily routine.

In addition to cardiovascular health, fish oil has been shown to improve brain function, boost your mood, enhance joint function and protect your vision.

[1] Mozaffarian D, et al. Omega-3 fatty acids and cardiovascular disease — effects on risk factors, molecular pathways, and clinical events. J Am Coll Cardiol. 2011.

[2] Mozaffarian, D, et al. Circulating Long-Chain Omega-3 Fatty Acids and Incidence of Congestive Heart Failure in Older Adults: The Cardiovascular Health Study. Ann Intern Med. 2011;155:160-170.

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