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Original article
Interaction between dietary marine-derived n-3 fatty acids intake and J-point elevation on the risk of cardiac death: a 24-year follow-up of Japanese men
  1. Takashi Hisamatsu1,2,3,
  2. Katsuyuki Miura1,2,
  3. Takayoshi Ohkubo2,4,
  4. Takashi Yamamoto3,
  5. Akira Fujiyoshi2,
  6. Naoko Miyagawa2,
  7. Aya Kadota5,
  8. Naoyuki Takashima2,
  9. Nagako Okuda6,
  10. Yasuhiro Matsumura7,
  11. Katsushi Yoshita8,
  12. Yoshikuni Kita2,
  13. Yoshitaka Murakami1,9,
  14. Yasuyuki Nakamura10,
  15. Tomonori Okamura11,
  16. Minoru Horie3,
  17. Akira Okayama12,
  18. Hirotsugu Ueshima1,2,
  19. for the NIPPON DATA80 Research Group
  1. 1Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
  2. 2Department of Health Science, Shiga University of Medical Science, Otsu, Japan
  3. 3Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan
  4. 4Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan
  5. 5Department of School Nursing and Health Education, Osaka Kyoiku University, Osaka, Japan
  6. 6Section of Shokuiku, Department of Nutritional Education, National Institute of Health and Nutrition, Tokyo, Japan
  7. 7Faculty of Health and Nutrition, Bunkyo University, Chigasaki, Japan
  8. 8Department of Food Science and Nutrition, Osaka City University, Osaka, Japan
  9. 9Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan
  10. 10Cardiovascular Epidemiology, Kyoto Women's University, Kyoto, Japan
  11. 11Department of Preventive Medicine and Public Health, Keio University, Tokyo, Japan
  12. 12First Institute for Health Promotion and Health Care, Tokyo, Japan
  1. Correspondence to Takashi Hisamatsu, Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Setatsukinowa-cho, Otsu, Shiga 520-2192, Japan; hisataka{at}


Objective Higher marine-derived n-3 fatty acids (MDn3FAs) intake reduces the risk of sudden cardiac death via antiarrhythmic effects. The article evaluates whether MDn3FAs intake attenuates the increased risk of cardiac death associated with J-point elevation (JPE), characterised by an elevation of QRS-ST junction (J-point) ≥0.1 mV on electrocardiography.

Design A prospective population-based cohort study.

Setting The National Survey on Circulatory Disorders and the National Nutrition Survey of Japan.

Participants A total of 4348 community-dwelling men (mean age 49.3 years), without cardiovascular diseases at baseline, from randomly selected areas across Japan.

Main outcome measures Cardiac death (200 men) during the 24-year follow-up.

Results Dietary MDn3FAs intake was assessed using a dietary method to estimate individual intake of household-based weighed food records for 3 days. Cox models were used to calculate HRs and 95% CIs adjusted for possible confounding factors. JPE was present in 340 participants (7.8%). The median daily intake of MDn3FAs was 0.35%kcal (0.92 g/day). The risk of cardiac death was significantly higher in participants with JPE than in those without JPE in the low intake group (<0.35%kcal; adjusted HR 3.51; 95% CI 1.84 to 6.73; p<0.001), but not in the high intake group (≥0.35%kcal; adjusted HR 1.09; 95% CI 0.56 to 2.16; p=0.795). The interaction between dietary MDn3FAs intake and JPE on the risk of cardiac death was statistically significant (p=0.006).

Conclusions The increased risk of cardiac death associated with JPE may be attenuated by higher dietary MDn3FAs intake.

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