The effect of marine n-3 polyunsaturated fatty acids on cardiac autonomic and hemodynamic function in patients with psoriatic arthritis: a randomised, double-blind, placebo-controlled trial.

Jeppe Hagstrup Christensen,Salome Kristensen,Erik Berg Schmidt,Esther Lindgreen,Claus Rasmussen,Annette Schlemmer,Martin Berg Johansen

doi:10.1186/s12944-016-0382-5

Jeppe Hagstrup Christensen, Salome Kristensen + Show 5 more

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https://doi.org/10.1186/s12944-016-0382-5

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Abstract

BackgroundThe aim of this study was to investigate the effect of marine n-3 polyunsaturated fatty acids (PUFA) on cardiac autonomic function and vascular function in patients with psoriatic arthritis.MethodsThe study was conducted as a randomized, double-blind, placebo-controlled trial, where 145 patients with psoriatic arthritis were supplemented with 3 g of n-3 PUFA or olive oil (control) daily for 24 weeks. Blood pressure, heart rate, heart rate variability (HRV), central blood pressure, pulse wave velocity (PWV) and fatty acid composition of granulocytes, were determined at baseline and after supplementation.ResultsAt baseline we found a significant difference in the mean of all normal RR intervals (inverse of heart rate, vary from beat to beat) when comparing subjects with the highest vs the lowest fish intake (p = 0.03). After supplementation for 24 weeks there was a trend towards an increase in RR (p = 0.13) and decrease in heart rate (p = 0.12) comparing the n-3 PUFA group with the control group. However, per-protocol analysis showed significantly increased RR (p = 0.01) and lowered heart rate (p = 0.01) in the n-3 PUFA supplemented patients compared with controls. Blood pressure, PWV and Central blood pressure did not change after supplementation with n-3 PUFA. Adjustment for disease activity and conventional cardiovascular risk factors did not change the results.ConclusionsMarine n-3 PUFA increased RR intervals in patients with psoriatic arthritis which may suggest a protective effect of n-3 PUFA against cardiovascular disease in this population.Trial registrationClinicaltrials.gov Identifier: NCT01818804

Highlights

The aim of this study was to investigate the effect of marine n-3 polyunsaturated fatty acids (PUFA) on cardiac autonomic function and vascular function in patients with psoriatic arthritis
Patients with inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus are at an increased risk of cardiovascular disease (CVD) [4] and recent observational studies indicate that Psoriatic arthritis (PsA) patients have an increased cardiovascular mortality and morbidity [5, 6]
The present study aimed to examine whether supplementation with a moderate to high (3 g) daily dose of marine n-3 PUFA for 24 weeks had a beneficial effect on cardiac autonomic and hemodynamic function represented by blood pressure (BP), heart rate (HR), heart rate variability (HRV), pulse wave velocity (PWV) and central BP in patients with PsA

Summary

Introduction

The aim of this study was to investigate the effect of marine n-3 polyunsaturated fatty acids (PUFA) on cardiac autonomic function and vascular function in patients with psoriatic arthritis. Psoriatic arthritis (PsA) is a chronic inflammatory joint disease occurring in 6–39% of patients with psoriasis and with a prevalence in the general population of approximately 0.2% [1,2,3]. Several studies have indicated that chronic inflammation may impair autonomic cardiac regulation leading to a decrease in heart rate variability (HRV) [8, 9]. A low HRV has been identified as an independent predictor of coronary heart disease [10], as well as malignant ventricular arrhythmias and sudden cardiac death [11,12,13,14,15]. Arterial stiffness has been recognised as an independent predictor of CVD [16, 17]. Studies using noninvasive methods such as pulse wave velocity (PWV) for evaluation of CVD risk have revealed increased arterial stiffness in patients with PsA [18,19,20]

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