(HealthDay News) — Twice-weekly fish intake is associated with a lower risk for major cardiovascular disease (CVD) and mortality in patients with prior CVD, but not the general population, according to a study published online in JAMA Internal Medicine.

Deepa Mohan, PhD, from the Madras Diabetes Research Foundation in India, and colleagues examined whether the associations between fish consumption and risk for CVD or risk for mortality differ between individuals with and individuals without vascular disease. The analysis included 191,558 individuals from four cohort studies: 147,645 individuals (139,827 without CVD and 7,818 with CVD) from 21 countries in the Prospective Urban Rural Epidemiology (PURE) study and 43,913 patients with vascular disease in 3 prospective studies from 40 countries.

The researchers found that during 9.1 years of follow-up in PURE, an intake of 350 g/week or more was not associated with the risk for major CVD (hazard ratio [HR], 0.95; 95% confidence interval [CI], 0.86 to 1.04) or total mortality (HR, 0.96; 95% CI, 0.88 to 1.05) compared with little or no fish intake (≤50 g/month). Among the cohorts of patients with vascular disease, risk was cut for major CVD (HR, 0.84; 95% CI, 0.73 to 0.96) and total mortality (HR, 0.82; 95% CI, 0.74 to 0.91) with intakes of at least 175 g/week (approximately 2 servings/week) versus ≤50 g/month. There were no further decreases in risk with consumption of ≥350 g/week. CVD status affected the association between fish intake and each outcome, with a lower risk found among patients with vascular disease but not among the general population.

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“This is by far the most diverse study of fish intake and health outcomes in the world and the only one with sufficient numbers with representation from high-, middle- and low-income countries from all inhabited continents of the world,” a coauthor said in a statement.

Several authors disclosed financial ties to the pharmaceutical industry.

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