Aims/Hypothesis: Aortic stiffness predicts all-cause and cardiovascular mortality in essential hypertension, diabetes and the community. Potential intermediaries in this relationship include serum fatty acids (FA). We examined whether serum FA influenced aortic stiffness, measured as pulse wave velocity (aPWV), and its impact on mortality.

Methods: After randomly sampling population registers, 174 nondiabetic participants had fasting blood samples and a 75g glucose challenge (GTT), measures of doppler-derived aortic PWV and then serum FA composition determined by HPLC. Mortality data over 18 years’ follow-up were obtained via the national registry and principal component (PC) analysis used for statistical modelling.

Results: Docosahexaenoic acid (DHA; ρ = −0.22; p = 0.02) and Arachidonic acid (AA; ρ = −0.25; p<0.001) were inversely related to PWV. PC analyses, including 10 measured serum FAs, ethnicity, age and sex, identified five components. SBP, PWV, smoking or central adiposity was directly related to Component 1 and inversely to component 4, whose pattern was higher AA, eicosapentaenoic (EPA) and DHA and lower oleic, palmitic (PA) and linoleic (LA) levels. Component 4 was associated with a decreased risk of mortality (HR 0.49 (0.39, 0.62) independent of PWV. Component 1, associated with increased mortality (HR = 1.13, 1.01–1.27), included people with higher levels of the saturated FAs (myristic and PA) but lower levels of polyunsaturated FAs (LA, dihomo-gamma-linolenic (DGLA) & AA).

Conclusion: Patterns of serum fatty acids, partially reflecting diet, are associated with mortality, perhaps by modulating large vessel vascular function.