The independent effects of eicosapentaenoic acid and docosahexaenoic acid on cardiovascular risk factors in humans

Mori, Trevor A.; Woodman, Richard

doi:10.1097/01.mco.0000214566.67439.58

Cited by 204 publications

(142 citation statements)

References 79 publications

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“…Omega-3 fatty acids derived from marine fish oil predominantly lower triglycerides, but may also have beneficial effects on HDL subfractions and LDL-particle size, as well as direct actions on the vasculature to reduce inflammation and endothelial cell activation [152]. In randomized, double-blind, controlled trials in T2D patients, omega-3 fatty acid supplementation improved acetylchollilne (Ach)-stimulated FABF [153], but not fasting brachial artery FMD [154,155].…”

Section: Lipid-regulating Therapymentioning

confidence: 99%

Endothelial Dysfunction in Diabetes: Pathogenesis, Significance, and Treatment

2013

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■ AbstractType 2 diabetes (T2D) markedly increases the risk of cardiovascular disease. Endothelial dysfunction (ED), an early indicator of diabetic vascular disease, is common in T2D and independently predicts cardiovascular risk. Although the precise pathogenic mechanisms for ED in T2D remain unclear, at inception they probably involve uncoupling of both endothelial nitric oxide synthase activity and mitochondrial oxidative phosphorylation, as well as the activation of vascular nicotinamide adenine dinucleotide phosphate oxidase. The major contributing factors include dyslipoproteinemia, oxidative stress, and inflammation. Therapeutic interventions are designed to target these pathophysiological factors that underlie ED. Therapeutic interventions, including lifestyle changes, antiglycemic agents and lipid-regulating therapies, aim to correct hyperglycemia and atherogenic dyslipidemia and to improve ED. However, high residual cardiovascular risk is seen in both research and clinical practice settings. Well-designed studies of endothelial function in appropriately selected volunteers afford a good opportunity to test new therapeutic interventions, paving the way for clinical trials and utilization in the care of the diabetic patient. However, based on the results from a recent clinical trial, niacin should not be added to a statin in individuals with low high-density lipoprotein cholesterol and very well controlled low-density lipoprotein cholesterol.

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Section: Lipid-regulating Therapymentioning

confidence: 99%

Endothelial Dysfunction in Diabetes: Pathogenesis, Significance, and Treatment

2013

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“…66/ -0 . 35 mmHg/g n-3 PUFA for systolic/diastolic BP (68,69) . The earlier conclusions were based on results from studies that used a mixture of EPA and DHA.…”

Section: N-3 Pufa and Plaque Stabilitymentioning

confidence: 99%

Similarities and differences between the effects of EPA and DHA on markers of atherosclerosis in human subjects

Kelley

Adkins

2012

Proc. Nutr. Soc.

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We have reviewed effects of long chain (LC) n-3 PUFA on markers of atherosclerosis in human subjects with a focus on individual effects of EPA and DHA. Initial results from epidemiological studies suggested that LC n-3 PUFA from fish oils (FO) reduced incidence of CVD; those results have been confirmed in interventional studies. Dietary intervention with n-3 PUFA decreased fasting and postprandial TAG, number of remnant-like chylomicron particles, large VLDL, and total and small dense LDL particles. It increased mean size of LDL particles by increasing number of large and decreasing those of small dense particles. With some exceptions, n-3 PUFA decreased blood pressure (BP) and heart rate (HR), flow-mediated dilation (FMD) and plasma concentrations of inflammatory markers. n-3 PUFA also decreased circulating adhesion molecules and intima-media thickness (IMT) in some but not other studies. For IMT, results varied with the sex and artery being examined. EPA effects on FMD are endothelial cell dependent, while those of DHA seem to be endothelial cell independent. Individually, both EPA and DHA decreased TAG and inflammatory markers, but only DHA decreased HR, BP and number of small dense LDL particles. Results varied because of dose and duration of n-3 PUFA, EPA:DHA, health status of subjects and other reasons. Future studies are needed to determine optimal doses of EPA and DHA individually, their synergistic, additive or antagonistic effects, and to understand underlying mechanisms. In conclusion, n-3 PUFA decreased several risk factors for atherosclerosis without any serious adverse effects. TAG: LDL size and numbers: Intima-media thickness: Blood pressureAtherosclerosis comes from the Greek words athero (meaning gruel or paste) and sclerosis (hardness). It is a common disorder of the arteries in which fat and other substances build up in and on the walls of arteries and form hard structures called plaques (1) . The plaques can make the artery narrow and less flexible, making it harder for blood to flow. If the coronary arteries become narrow, blood flow to the heart can slow down or stop. This can cause chest pain (stable angina), shortness of breath, heart attack and other symptoms. Pieces of plaque can break off and move through the bloodstream (embolisation). This is a common cause of heart attack and stroke. Blood clots can also form around a tear (fissure) in the plaque and block blood flow. If the clot moves into an artery in the heart, lungs or brain, it can cause a stroke, heart attack or pulmonary embolism (2) . Eighty million American adults (approximately one in three) have CVD (3) . CVD is the number one cause of deaths in the US accounting for 34 % of all deaths or 2400 deaths each day. It is a major public health problem with an annual economic loss of $400 billion (3) .

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“…n-3 Fatty acids have multiple effects benefiting a number of cardiometabolic risk factors including blood pressure (5)(6)(7)(8) and cardiac function (4,7) , arterial compliance (9,10) , vascular reactivity (11,12) , lipid metabolism (13,14) , reduced leucocyte-derived cytokine formation (15) , anti-platelet (16) , anti-inflammatory (17,18) and pro-resolving (19) effects, and antioxidative actions (20) . There is also evidence from studies in human subjects that EPA and DHA have differential effects on blood pressure, heart rate, lipids and vascular reactivity (21) . The aim of the present paper is to review the evidence for beneficial effects of n-3 fatty acids on cardiometabolic risk factors, concentrating particularly on randomised controlled studies in human subjects.…”

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confidence: 99%

Dietary n-3 PUFA and CVD: a review of the evidence

Mori

2013

Proc. Nutr. Soc.

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Many clinical and epidemiological studies have shown that the polyunsaturated n-3 fatty acids EPA and DHA from fish and fish oils, provide cardiovascular protection, particularly in the setting of secondary prevention. n-3 Fatty acids beneficially influence a number of cardiometabolic risk factors including blood pressure, cardiac function, vascular reactivity and lipids, as well as having anti-platelet, anti-inflammatory and anti-oxidative actions. They do not appear to adversely interact with other medications such as statins and other lipid-lowering drugs or antihypertensive medications. n-3 Fatty acids have gained widespread usage by general practitioners and clinicians in a number of clinical settings such as pregnancy and infant development, secondary prevention in CHD patients, treatment of dyslipidaemias and haemodialysis patients. Small doses are achievable with consumption of two to three oily fish meals per week or via purified encapsulated preparations now readily available. n-3 Fatty acids, particularly when consumed as fish, should be considered an important component of a healthy diet. The present paper reviews the effects of n-3 fatty acids on cardiometabolic risk factors, concentrating particularly on the evidence from randomised controlled studies in human subjects.

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The independent effects of eicosapentaenoic acid and docosahexaenoic acid on cardiovascular risk factors in humans

Abstract: Available evidence strongly suggests that eicosapentaenoic acid and docosahexaenoic acid have differing haemodynamic and anti-atherogenic properties. The effects of the two fatty acids may also differ depending on the target population.

Cited by 204 publications

References 79 publications

Endothelial Dysfunction in Diabetes: Pathogenesis, Significance, and Treatment

Endothelial Dysfunction in Diabetes: Pathogenesis, Significance, and Treatment

Similarities and differences between the effects of EPA and DHA on markers of atherosclerosis in human subjects

Dietary n-3 PUFA and CVD: a review of the evidence

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