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n -6 PUFA, especially linoleic acid (LA) but also arachidonic acid (AA), have been inversely associated with CHD. However, mechanisms underlying these associations are not fully known. We investigated the associations of the serum concentrations of total n -6 PUFA, LA, AA, γ -linolenic acid (GLA) and dihomo- γ -linolenic acid (DGLA), with the odds of myocardial ischaemia during exercise, a predictor of future cardiac events. A total of 1871 men without a history of CHD from the Kuopio Ischaemic Heart Disease Risk Factor Study (KIHD) aged 42-60 years were included. All participants performed a maximal symptom-limited exercise stress test, using an electrically braked bicycle ergometer. Multivariable-adjusted logistic regression was used to assess the OR for exercise-induced myocardial ischaemia in quartiles of the serum n -6 PUFA concentrations. After multivariable adjustment, men in the highest v . the lowest serum AA concentration had 50 % lower odds for exercise-induced myocardial ischaemia (OR 0·50, 95 % CI 0·34, 0·76; P -trend across quartiles < 0·001). For the other PUFA, the OR (95 % CI) were 1·00 (0·69, 1·46; P -trend = 0·89) for LA, 1·07 (0·75, 1·53; P -trend = 0·40) for GLA and 0·74 (0·51, 1·07; P -trend = 0·16) for DGLA. Among the n -6 PUFA, higher serum concentration of AA was associated with lower odds for myocardial ischaemia during an exercise test in middle-aged and older men. This may provide one mechanism for the previously observed possible cardioprotective properties of AA. Our findings also suggest that n -6 PUFA should not be considered as one homogenous group.

Low intake or tissue concentrations of the n -6 PUFA, especially to the major n -6 PUFA linoleic acid (LA), and low exercise cardiac power (ECP) are both associated with CVD risk. However, associations of the n -6 PUFA with ECP are unknown. The aim of the present study was to explore cross-sectional associations of the serum total n -6 PUFA, LA, arachidonic acid (AA), γ -linolenic acid (GLA) and dihomo- γ -linolenic acid (DGLA) concentrations with ECP and its components. In total, 1685 men aged 42-60 years from the Kuopio Ischaemic Heart Disease Risk Factor Study and free of CVD were included. ANCOVA was used to examine the mean values of ECP (maximal oxygen uptake (VO 2max )/maximal systolic blood pressure (SBP)) and its components in quartiles of the serum total and individual n -6 PUFA concentrations. After multivariable adjustments, higher serum total n -6 PUFA concentration was associated with higher ECP and VO 2max (for ECP, the extreme-quartile difference was 0·77 ml/mmHg (95 % CI 0·38, 1·16, P across quartiles < 0·001) and for VO for trend across quartiles < 0·001) and for VO 2max 157 ml/min (95 % CI 85, 230, P for trend -6 PUFA GLA and DGLA were associated with higher maximal SBP during exercise test and DGLA also with higher VO 2max but neither with ECP. In conclusion, especially LA concentration was associated with higher ECP. This may provide one mechanism for the cardioprotective properties of, especially, LA.n -6 PUFA GLA and DGLA were associated with higher maximal SBP during exercise test and DGLA also with higher VO 2max but neither with ECP. In conclusion, especially LA concentration was associated with higher ECP. This may provide one mechanism for the cardioprotective properties of, especially, LA.