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(Stroke. 1996;27:204-209.)
© 1996 American Heart Association, Inc.
Articles |
From the Departments of Neurology (A.J.O.) and Preventive Medicine (A.J.O., M.L.D., A.R.D., J.S.), Northwestern University Medical School, Chicago, Ill, and the Department of Epidemiology, School of Public Health, University of Texas Health Science Center (Houston) (R.B.S.).
Correspondence to Anthony J. Orencia, MD, PhD, Indiana University, 541 Clinical Drive CL365, Indianapolis, IN 46202.
Background and Purpose Evidence of a relationship of fish intake to stroke incidence or mortality is weak. This report examines the association of fish consumption with stroke.
Methods A cohort of 2107 men aged 40 to 55 years from the
Chicago Western Electric Study who were free of coronary heart
disease and stroke through their first annual reexamination was
investigated in relation to baseline fish intake and 30-year risk of
fatal and nonfatal stroke. Data on baseline fish intake, categorized
into four levels (
35 g/d, 18 to 34 g/d, 1 to 17 g/d, and 0 g/d), were
available for 1847 men. Average values of macronutrients and
micronutrients from the first two examinations and major
coronary and stroke risk factors were assessed in relation to
fish consumption. Stroke mortality was ascertained from death
certificates and nonfatal stroke from records of the Health Care
Financing Administration.
Results During 46 426 person-years of follow-up,
76 stroke deaths occurred. Men consuming
35 g/d of fish (highest
level) had a higher age-adjusted death rate from stroke (23.5 per
10 000 person-years) than men in the three other categories of
fish consumption. Based on a Cox proportional hazards regression model
with adjustment for age, systolic blood pressure, cigarette
smoking, serum cholesterol level, diabetes,
electrocardiographic abnormalities, and table salt use, hazards ratios
(and 95% confidence intervals) for fish consumers compared with
nonconsumers were 1.34 (0.53 to 3.41) for
35 g/d, 0.96 (0.41 to 2.21)
for 18 to 34 g/d, and 1.00 (0.43 to 2.33) for 1 to 17 g/d.
Age-adjusted and multivariate analyses for
fatal and nonfatal strokes (n=222) yielded similar results.
Conclusions With stroke rates highest in the subgroup reporting highest fish intake, these data do not support the hypothesis of an inverse association of fish consumption with strokes.
Key Words: diet epidemiology risk factors
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