Abstract 13273: Long-term Administration of Eicosapentaenoic Acid Prevents an Excessive Blood Pressure Elevation During Exercise Simulating Ordinary Activities of Daily Living via the Improvement of Vascular Endothelial Dysfunction in Patients With Hypertension

Abstract

[Background] Excessive blood pressure (BP) elevation was frequently observed during exercise even at low or moderate intensity in patients with hypertension (HT), although their BP at rest was successfully controlled with antihypertensives. Several studies documented that vascular endothelial dysfunction induced excessive BP elevation in their ordinary activities of daily living (ADL). On the other hands, eicosapentaenoic acid (EPA) reduces oxidative stress and vascular inflammation resulting in the improvement of vascular endothelial dysfunction. However, it is still unknown whether long-term administration of EPA ameliorates excessive BP elevation in ordinary ADL. This study aimed to investigate the influence of EPA on vascular endothelial dysfunction and excessive BP elevation during exercise at moderate intensity in HT patients. [Methods] We recruited 60 HT outpatients whose resting blood pressure was successfully controlled below 140/90 mmHg. Patients were assigned to EPA(+) group or EPA(-) group in crossover method. They were administered antihypertensives with or without 1,800 mg of EPA daily for 10 months in the EPA(+) and EPA(-) groups, respectively. We measured serum concentrations of EPA, arachidonic acid (AA) and EPA/AA ratio. We assessed reactive hyperemia index (RHI) and thrombomodulin (TM) as a parameter of vascular endothelial function. BP elevation during exercise was determined as the difference from systolic BP (SBP) at rest to peak SBP during a cycle ergometer exercise test (SBP). The exercise intensity was given as 75% of peak heart rate (HR) obtained from a treadmill exercise test, which indicates the intensity of ordinary ADL. We compared all parameters between the two groups and analyzed the relationship between RHI and SBP. [Results] EPA, EPA/AA ratio and RHI were significantly higher in the EPA(+) group than in the EPA(-) group (P<0.01, respectively). SBP and TM were significantly lower in the EPA(+) group than in the EPA(-) group (P<0.05, respectively). RHI was negatively correlated with SBP (r=-0.313, P<0.05). [Conclusion] Long-term administration of EPA prevented an excessive BP elevation during exercise simulating ordinary ADL via the improvement of vascular endothelial dysfunction in HT patients.