Biomarkers of Fish Consumption and Risk of Stroke or Myocardial Infarction

.......................................................... 4 SUMMARY IN SWEDISH – SAMMANFATTNING PÅ SVENSKA ............................................................. 6 ABBREVIATIONS ................................................. 7 ORIGINAL PAPERS .............................................. 8 INTRODUCTION .................................................. 9 Cardiovascular disease ......................................................................................................................... 9 Atherosclerosis .......................................................................................................................................... 9 Stroke ........................................................................................................................................................... 9 Myocardial Infarction............................................................................................................................... 9 Fish consumption and cardiovascular disease ...................................................................... 10 Mechanisms for EPA and DHA affecting cardiovascular risk .................................................. 10 Triglyceride-lowering ............................................................................................................................. 11 Blood pressure-lowering ...................................................................................................................... 11 Heart Rate-lowering .............................................................................................................................. 11 Antiarrhythmic effects .......................................................................................................................... 11 Antiinflammatory effects ..................................................................................................................... 11 Decreased platelet aggregation ........................................................................................................ 12 Atherosclerotic plaque stabilization ................................................................................................. 12 Previous studies on consumption of fish or marine omega-3 fatty acids and risk of cardiovascular disease ........................................................................................................ 12 Randomized controlled trials .............................................................................................................. 12 Reviews ...................................................................................................................................................... 12 Selenium and cardiovascular disease ........................................................................................ 13 Methylmercury ......................................................................................................................................... 13 Sources of pollution ............................................................................................................................... 13 Transmission of mercury ..................................................................................................................... 13 Dietary sources of methylmercury................................................................................................... 14 Health effects of methylmercury .................................................................................................. 14 Cardiovascular effects of methylmercury ...................................................................................... 14 Biomarkers of fish consumption – EPA+DHA and methylmercury ........................... 15