Abstract / Summary
Background Anthocyanins and anthocyanin‐rich berries have demonstrated lipid‐lowering and anti‐inflammatory effects; however, associations with cardiovascular disease remain mixed. We therefore examined anthocyanin and blueberry intake for prospective associations with cardiovascular disease risk and cross‐sectional associations with lipids and hs‐CRP (high‐sensitivity C‐reactive protein) in the WHS (Women's Health Study). Methods Among 38 088 women who completed a baseline semiquantitative food frequency questionnaire in 1992 to 1995, we estimated intake of total anthocyanins, 6 anthocyanin subclasses, and blueberries. Multivariable hazard ratios (HRs) were calculated for confirmed major adverse cardiovascular events, including nonfatal myocardial infarction, nonfatal stroke, and cardiovascular disease death. In a subset of 26 912 women with baseline blood samples, multivariable odds ratios were calculated for adverse lipid and hs‐CRP levels. Results During a median 28.0‐year follow‐up, 2752 major adverse cardiovascular event cases occurred. Age‐, energy‐, and WHS treatment–adjusted HRs across quintiles of total anthocyanin intake were 1.00 (reference), 0.87 (95% CI, 0.78–0.98), 0.79 (95% CI, 0.70–0.89), 0.81 (95% CI, 0.72–0.91), and 0.88 (95% CI, 0.79–0.99) ( P ‐trend=0.23). Further adjustment for clinical, lifestyle, and dietary factors showed no significant associations with major adverse cardiovascular events or their components, with similar null findings observed for anthocyanin subclasses and blueberries. In cross‐sectional analyses, higher total anthocyanins and anthocyanin subclasses, except pelargonidin, were significantly associated with lower multivariable‐adjusted odds of adverse high‐density lipoprotein cholesterol and triglycerides (all other P ‐trend<0.05). Conclusions In the WHS, anthocyanin and blueberry intake were not significantly associated with cardiovascular disease risk. However, higher anthocyanin intake was cross‐sectionally associated with lower odds of adverse high‐density lipoprotein cholesterol and triglycerides.