n-3 Fatty acids, hypertension and risk of cognitive decline among older adults in the Atherosclerosis Risk in Communities (ARIC) study

Public Health Nutr. 2008 Jan;11(1):17-29. doi: 10.1017/S1368980007000080. Epub 2007 Jul 12.


Objective: Recent research indicates that n-3 fatty acids can inhibit cognitive decline, perhaps differentially by hypertensive status.

Design: We tested these hypotheses in a prospective cohort study (the Atherosclerosis Risk in Communities). Dietary assessment using a food-frequency questionnaire and plasma fatty acid exposure by gas chromatography were completed in 1987-1989 (visit 1), while cognitive assessment with three screening tools--the Delayed Word Recall Test, the Digit Symbol Substitution Test of the Wechsler Adult Intelligence Scale-Revised and the Word Fluency Test (WFT)--was completed in 1990-1992 (visit 2) and 1996-1998 (visit 4). Regression calibration and simulation extrapolation were used to control for measurement error in dietary exposures.

Setting: Four US communities--Forsyth County (North Carolina), Jackson (Mississippi), suburbs of Minneapolis (Minnesota) and Washington County (Maryland).

Subjects: Men and women aged 50-65 years at visit 1 with complete dietary data (n = 7814); white men and women in same age group in the Minnesota field centre with complete plasma fatty acid data (n = 2251).

Results: Findings indicated that an increase of one standard deviation in dietary long-chain n-3 fatty acids (% of energy intake) and balancing long-chain n-3/n-6 decreased the risk of 6-year cognitive decline in verbal fluency with an odds ratio (95% confidence interval) of 0.79 (0.66-0.95) and 0.81 (0.68-0.96), respectively, among hypertensives. An interaction with hypertensive status was found for dietary long-chain n-3 fatty acids (g day-1) and WFT decline (likelihood ratio test, P = 0.06). This exposure in plasma cholesteryl esters was also protective against WFT decline, particularly among hypertensives (OR = 0.51, P < 0.05).

Conclusion: One implication from our study is that diets rich in fatty acids of marine origin should be considered for middle-aged hypertensive subjects. To this end, randomised clinical trials are needed.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Atherosclerosis / complications
  • Cognition Disorders / complications
  • Cognition Disorders / prevention & control*
  • Cohort Studies
  • Fatty Acids, Omega-3 / administration & dosage*
  • Female
  • Humans
  • Hypertension / classification
  • Hypertension / complications*
  • Logistic Models
  • Male
  • Maryland
  • Middle Aged
  • Minnesota
  • Mississippi
  • Multivariate Analysis
  • North Carolina
  • Nutrition Assessment
  • Prospective Studies
  • Risk Factors
  • United States


  • Fatty Acids, Omega-3