Arachidonic Acid, but Not Omega-3 Index, Relates to the Prevalence and Progression of Abdominal Aortic Aneurysm in a Population-Based Study of Danish Men

J Am Heart Assoc. 2018 Jan 26;7(3):e007790. doi: 10.1161/JAHA.117.007790.


Background: Animal models support dietary omega-3 fatty acids protection against abdominal aortic aneurysm (AAA), but clinical data are scarce. The sum of red blood cell proportions of the omega-3 eicosapentaenoic and docosahexaenoic acids, known as omega-3 index, is a valid surrogate for long-term omega-3 intake. We investigated the association between the omega-3 index and the prevalence and progression of AAA. We also investigated associations between AAA and arachidonic acid, an omega-6 fatty acid that is a substrate for proinflammatory lipid mediators.

Methods and results: We obtained blood samples from 498 AAA patients (maximal aortic diameter ≥30 mm) within a population-based ultrasound-screening trial in men and from 199 age-matched controls who screened negative. We determined the fatty acids of red blood cells by gas chromatography. During a median follow-up of 4.85 years, 141 AAA patients reached criteria for vascular surgical repair. Participants were high consumers of omega-3 (average omega-3 index: 7.6%). No significant associations were found for omega-3 index. In contrast, arachidonic acid in AAA patients was higher than in controls (P<0.001), and individuals in the upper tertile of arachidonic acid at baseline had higher probability of having AAA (odds ratio: 1.309; 95% confidence interval, 1.021-1.678; P=0.033). AAA patients at the upper tertile of arachidonic acid at baseline had a 54% higher risk of needing surgical repair during follow-up (hazard ratio: 1.544; 95% confidence interval, 1.127-2.114; P=0.007).

Conclusions: Omega-3 index is unrelated to men with AAA from a country in which fish consumption is customarily high. Arachidonic acid is associated with AAA presence and progression.

Clinical trial registration: URL: Unique identifier: NCT00662480.

Keywords: abdominal aortic aneurysm; diet; inflammation.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aortic Aneurysm, Abdominal / blood*
  • Aortic Aneurysm, Abdominal / diagnostic imaging
  • Aortic Aneurysm, Abdominal / epidemiology*
  • Arachidonic Acid / blood*
  • Biomarkers / blood
  • Denmark / epidemiology
  • Diet
  • Disease Progression
  • Fatty Acids, Omega-3 / blood
  • Humans
  • Male
  • Prevalence
  • Prognosis
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Time Factors
  • Ultrasonography


  • Biomarkers
  • Fatty Acids, Omega-3
  • Arachidonic Acid

Associated data