Effects on blood pressure of omega 3 fats in subjects at increased risk of cardiovascular disease.

Vandongen, R.; Mori, Trevor A.; Burke, Valerie; Beilin, Lawrence J.; Morris, Jenny; Ritchie, Jackie

doi:10.1161/01.hyp.22.3.371

Cited by 46 publications

(25 citation statements)

References 28 publications

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“…rate similar to those seen in the present study have been associated with consumption of fish oils or fish in humans, 2,15 raising the likelihood of an autonomic/cardiac component to the antihypertensive effect. In addition, it is worth noting that in animal studies, 3 fatty acids are incorporated into myocardial cells and have potent antiarrhythmic effects.…”

Section: Discussionsupporting

confidence: 85%

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Effects of Dietary Fish and Weight Reduction on Ambulatory Blood Pressure in Overweight Hypertensives

et al. 1998

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Abstract-Obesity is a major factor contributing to hypertension and increased risk of cardiovascular disease. Regular consumption of dietary fish and 3 fatty acids of marine origin can lower blood pressure (BP) levels and reduce cardiovascular risk. This study examined the potential effects of combining dietary fish rich in 3 fatty acids with a weight loss regimen in overweight hypertensive subjects, with ambulatory BP levels as the primary end point. Using a factorial design, 69 overweight medication-treated hypertensives were randomized to a daily fish meal (3.65 g 3 fatty acids), weight reduction, the 2 regimens combined, or a control regimen for 16 weeks. Sixty-three subjects with a meanϮSEM body mass index of 31.6Ϯ0.5 kg/m 2 completed the study. Weight fell by 5.6Ϯ0.8 kg with energy restriction. Dietary fish and weight loss had significant independent and additive effects on 24-hour ambulatory BP. Effects were greatest on awake systolic and diastolic BP (PϽ0.01); relative to control, awake pressures fell 6.0/3.0 mm Hg with dietary fish alone, 5.5/2.2 mm Hg with weight reduction alone, and 13.0/9.3 mm Hg with fish and weight loss combined. These results also remained significant after further adjustment for changes in urinary sodium, potassium, or the sodium/potassium ratio, as well as dietary macronutrients. Dietary fish also significantly reduced 24-hour (Ϫ3.1Ϯ1.4 bpm, Pϭ0.036) and awake (Ϫ4.2Ϯ1.6 bpm, Pϭ0.013) ambulatory heart rates. Weight reduction had a significant effect on sleeping heart rate only (Ϫ3.2Ϯ1.7 bpm, Pϭ0.037). Combining a daily fish meal with a weight-reducing regimen led to additive effects on ambulatory BP and decreased heart rate. The effects were large, suggesting that cardiovascular risk and antihypertensive drug requirements are likely to be reduced substantially by combining dietary fish meals rich in 3 fatty acids with weight-loss regimens in overweight medication-treated hypertensives. The reduction in heart rate seen with dietary fish suggests a cardiac/autonomic component, as well as vascular effects, of increased consumption of 3 fatty acid from fish. (Hypertension. 1998;32:710-717.) Key Words: fish Ⅲ 3 fatty acids Ⅲ weight control Ⅲ blood pressure Ⅲ obesity S everal randomized controlled trials have shown that fish oils may lower blood pressure (BP), 1-4 although the effects have been most clear-cut in hypertensive subjects treated with relatively large doses of 3 fatty acids. 5,6 On the other hand, population studies suggest that regular consumption of even small amounts of fish may reduce the risk of coronary heart disease, 7 an effect presumed to be due to actions of 3 fatty acids on a variety of mechanisms underlying atherosclerosis. 8 Obesity is a major factor contributing to hypertension, and weight loss reduces BP in overweight hypertensives. 9 In addition, hypertension and obesity are both associated with impaired endothelial function. 10,11 Because 3 fatty acids improve endothelial dilator function and vascular reactivity, 12,13 we hypothesized that combining weight ...

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Section: Discussionsupporting

confidence: 85%

“…These same subjects were offered a weight-loss program on completion of the study. Participants taking fish followed diets similar to one of our previous studies 15,16 and were instructed to eat 1 fish meal daily. A selection of previously analyzed fish from the same batch was supplied free of cost.…”

Section: Dietary Education and Interventionmentioning

confidence: 99%

Effects of Dietary Fish and Weight Reduction on Ambulatory Blood Pressure in Overweight Hypertensives

et al. 1998

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“…33 Reductions in HR similar to those seen in the present study have been reported after the consumption of fish or fish oil supplements. 12,34 We have shown a decrease of 3.1Ϯ1.4 bpm (Pϭ0.036) in 24-hour and 4.2Ϯ1.6 bpm (Pϭ0.013) in daytime HR after daily consumption of fish for 16 weeks in overweight, treated hypertensives. 15 The reductions in mean 24-hour, daytime, and nighttime HR with DHA in the present study were significant and comparable to those reported previously.…”

Section: Discussionmentioning

confidence: 83%

Docosahexaenoic Acid but Not Eicosapentaenoic Acid Lowers Ambulatory Blood Pressure and Heart Rate in Humans

et al. 1999

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Abstract-Animal studies suggest that the 2 major 3 fatty acids found in fish, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), may have differential effects on blood pressure (BP) and heart rate (HR). The aim of this study was to determine whether there were significant differences in the effects of purified EPA or DHA on ambulatory BP and HR in humans. In a double-blind, placebo-controlled trial of parallel design, 59 overweight, mildly hyperlipidemic men were randomized to 4 g/d of purified EPA, DHA, or olive oil (placebo) capsules and continued their usual diets for 6 weeks. Fifty-six subjects completed the study. Key Words: eicosapentaenoic acid Ⅲ docosahexaenoic acid Ⅲ fatty acids Ⅲ blood pressure Ⅲ heart rate C urrent evidence from epidemiological studies, clinical trials, and experimental animal studies suggests that 3 fatty acids of marine origin may be protective against cardiovascular disease. 1 Most studies that assessed the potential cardiovascular benefits of 3 fatty acids have focused largely on the importance of eicosapentaenoic acid (EPA), with little attention given to the relative effect of docosahexaenoic acid (DHA). This is probably attributable to the fact that the majority of commercial marine oil preparations as well as most, but not all, fish species contain more EPA than DHA. In addition, EPA, unlike DHA, is a substrate for the cyclooxygenase and lipoxygenase enzymes involved in eicosanoid metabolism.Fish oil supplementation in humans results in substantial increases in plasma and tissue 3 fatty acids, particularly EPA and DHA, but with variable incorporation in different phospholipid classes in different tissues. In vitro animal and human studies have shown that EPA and DHA are differentially incorporated into plasma, 2 platelet, 3,4 and tissue lipids. 4 These differences may play an important role in the utilization and metabolism of the 2 fatty acids. For example, EPA and DHA differ in their effects on membrane fluidity and the activities of membrane-bound enzymes 5 and on neutrophilmediated endothelial detachment. 6 Compelling evidence shows that in vitro DHA but not EPA decreased cytokine-induced expression of endothelial leukocyte adhesion molecules. 7 Recent reports have described differences in lipid metabolism 8,9 and platelet aggregation. 10 An antihypertensive effect of fish oils has been demonstrated in hypertensive patients, 11-14 although generally only when relatively large doses of fish oils have been used. We recently reported that daily fish meals that provide 3.65 g/d of 3 fatty acids significantly reduced blood pressure (BP) in overweight, treated hypertensives. 15 This study addresses the question of whether EPA and DHA have differential effects on BP and heart rate (HR) in humans. In support of a differential effect of EPA and DHA on BP control, McLennan et al 16 recently reported that DHA was more effective than EPA at retarding the development of hypertension in spontaneously hypertensive rats (SHR) but not in adult SHR with already established hyperten...

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“…In parallel intervention trials, a modest reduction in blood pressure was achievable by fish consumption in patients with hypertension (81,82). In normotensive subjects, no reduction in blood pressure during fish intake was recorded (78,83,84).…”

Section: Fish and Blood Pressurementioning

confidence: 99%

Fish and cardiovascular health

Undeland

Ellegård

Sandberg

2004

Scandinavian Journal of Nutrition

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The antiatherogenic and antithrombotic effects of fish-oil-derived n-3 (omega-3) polyunsaturated fatty acids have given these compounds a dominating role in explaining the tentatively beneficial effects of fish, e.g. in the prevention of cardiovascular disease (CVD). As a result, the words ''omega-3'' and ''fish'' are often lumped together in both experimental studies and reviews. There are, however, strong reasons for separating fish lipids from whole fish muscle. The fish muscle matrix is highly complex, and many other compounds therein have been suggested as bioactive. This review summarizes data from epidemiological and intervention studies addressing effects of fish consumption per se on CVD. Potential roles of fish in CVD protection, and some risks connected to excessive fish eating, i.e. biocides and oxidation, are also discussed. Twelve out of 18 prospective cohort studies, two out of two case Á/control studies and two out of three ecological studies indicated reduced coronary mortality among subpopulations eating more fish, often at low fish intakes. Two cohort studies indicated increased risk for cardiovascular mortality. Out of 16 epidemiological studies in total, six prospective cohort studies, two case Á/control studies and one ecological study indicated a reduced risk of coronary morbidity with higher fish consumption, and one cohort study indicated an elevated risk of coronary morbidity. Two intervention studies on men with coronary heart disease produced different results, one indicating decreased total mortality, with lower coronary morbidity, but the other indicating an elevated risk for coronary mortality without affecting total morbidity. Thus, ample epidemiological data favour fish intake for reducing mortality and morbidity in cardiovascular disease, although evidence from intervention studies is inconsistent. Among risk factors for CVD that have been proven to be affected by a fish-containing diet are high-density lipoprotein cholesterol, serum triglycerides and blood clotting, the former increasing and the latter two decreasing.

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Effects on blood pressure of omega 3 fats in subjects at increased risk of cardiovascular disease.

Cited by 46 publications

References 28 publications

Effects of Dietary Fish and Weight Reduction on Ambulatory Blood Pressure in Overweight Hypertensives

Effects of Dietary Fish and Weight Reduction on Ambulatory Blood Pressure in Overweight Hypertensives

Docosahexaenoic Acid but Not Eicosapentaenoic Acid Lowers Ambulatory Blood Pressure and Heart Rate in Humans

Fish and cardiovascular health

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