Abstract
BackgroundOmega–3 fatty acids prevent cardiovascular disease (CVD) events in patients with myocardial infarction or heart failure. Benefits in patients without overt CVD have not been demonstrated, though most studies did not use treatment doses (3.36 g) of omega-3 fatty acids. Arterial stiffness measured by pulse wave velocity (PWV) predicts CVD events independent of standard risk factors. However, no therapy has been shown to reduce PWV in a blood pressure-independent manner. We assessed the effects of esterified omega–3 fatty acids on PWV and serum markers of inflammation among patients with hypertension.Design and methodsWe performed a prospective, randomized; double-blinded pilot study of omega-3 fatty acids among 62 patients in an urban, safety net hospital. Patients received 3.36 g of omega–3 fatty acids vs. matched placebo daily for 3-months. The principal outcome measure was change in brachial-ankle PWV. Serum inflammatory markers associated with CVD risk were also assessed.ResultsThe majority (71 %) were of Latino ethnicity. After 3-months, mean change in arterial PWV among omega-3 and placebo groups was −97 cm/s vs. −33 cm/s respectively (p = 0.36 for difference, after multivariate adjustment for baseline age, systolic blood pressure, and serum adiponectin). Non-significant reductions in lipoprotein-associated phospholipase A2 (LpPLA2) mass and high sensitivity C-reactive protein (hsCRP) relative to placebo were also observed (p = 0.08, and 0.21, respectively).ConclusionHigh-dose omega-3 fatty acids did not reduce arterial PWV or markers of inflammation among patients within a Latino-predominant population with hypertension.Clinical trial registrationNCT00935766, registered July 8 2009.
Highlights
Omega–3 fatty acids prevent cardiovascular disease (CVD) events in patients with myocardial infarction or heart failure
Baseline characteristics were well matched; pulse wave velocity (PWV) values did not differ by randomization group
Reductions were seen in mean high sensitivity C-reactive protein (hsCRP) (−0.9 mg/L vs. 0.9 mg/L in placebo group) and lipoprotein-associated phospholipase A2 (Lp-PLA2) mass (−18.1 ng/mL vs. −6.1 ng/mL)
Summary
Omega–3 fatty acids prevent cardiovascular disease (CVD) events in patients with myocardial infarction or heart failure. Benefits in patients without overt CVD have not been demonstrated, though most studies did not use treatment doses (3.36 g) of omega-3 fatty acids. No benefits have been reported among patients without documented CVD [3, 4] It is unclear if the relatively low dose (1g) of omega-3 fatty acids. Omega-3 fatty acids reduce inflamation [7], but improvements in pulse wave velocity (PWV), have not been demonstrated. This may reflect inadequate dosing or a lower baseline CVD risk among populations studied. Despite 12-months of therapy with 1.8 g of omega-3 fatty
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