The relationship between consumption of sport-caught fish from Lake Ontario and cardiovascular disease and risk factors in the New York State Anglers Cohort Study; Implications of PCB and omega-3 fatty acids in fish consumption
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Background: Fish consumption has often been attributed to have beneficial effects on cardiovascular health including high cholesterol, hypertension and myocardial infarction. It is currently unknown though whether chemical pollutants in fish could adversely affect these cardiovascular events. Great Lakes sport-caught fish are known to have much higher polychlorinated biphenyl levels and consumption of sport-caught fish is a major route for human exposure. Purpose: The aim of this thesis is to assess the association between sport-caught fish from Lake Ontario and its tributaries and incident cardiovascular events in the New York State Angler Cohort Study. Methods: The New York State Angler Cohort Study is a prospective cohort study. At baseline (1991), self-reported consumption, including duration and frequency of specific species of sport-caught fish from Lake Ontario was assessed. In 2008, a follow-up self-administered mailed questionnaire was completed by 2509 of the cohort members. This follow-up questionnaire queried incident diagnoses of high cholesterol, hypertension, and non-fatal myocardial infarction. We used logistic regression to estimate odds ratios and 95% confidence intervals for fish consumption and these CVD events. Results: High frequency of fish consumption from Lake Ontario at baseline was not associated with high cholesterol (OR=1.03, 0.75-1.43) or hypertension (OR=0.98, 0.68-1.40). Effect modification by age, BMI, was not evident. High frequency of fish consumption was potentially, although non-significantly associated with myocardial infarction (OR=1.65, 0.72-3.79). Effect modification by age, BMI, and sex was not evident. However effect modification by high cholesterol was observed; the association between fish consumption from Lake Ontario and incident MI (Those with high cholesterol, OR=3.46, 1.08-11.13 and those without high cholesterol, OR=1.01, 0.25-4.03). Hypertension did not modify this association. Conclusions: Consumption of sport-caught fish from Lake Ontario at any level did not appear to be associated with high cholesterol or hypertension. Initial logistic regression results indicated a potential positive association with myocardial infarction. Further assessment by evaluating potential effect modification by either prevalent or incident cases of high cholesterol and hypertension indicated that the association between fish consumption from Lake Ontario and the outcome of incident myocardial infarction was being modified by both co-morbidities. Ultimately, increased consumption of sport-caught fish from Lake Ontario is not likely associated with an increased odds of developing high cholesterol, hypertension or myocardial infarction.