Very Long Chain Marine n-3 Polyunsaturated Fatty Acids in Atherothrombotic Heart Disease. A Brief Review, with a Focus on Metabolic Effects

Abstract

The global burden of atherothrombotic heart disease should be considered as a life-style disorder where differences in dietary habits and related risk factors like limited physical activity and adiposity together play important roles. Related metabolic changes have been scientifically elucidated in recent decades, and the role of the very-long-chain marine fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been much focused on, especially their possible effects on processes like inflammation and thrombosis. In the present brief review of related metabolic mechanisms, the effects of these fatty acids in a clinical setting have been referred to, including some of the authors’ work on this topic. The main focus is the divergent results in the field and the important differences between the study population, the type of supplements and fresh marine sources, the proportion of EPA versus DHA dosages, and the duration of supplementation in clinical trials. We conclude that daily intake of at least 1 g of EPA + DHA may improve a dysmetabolic state in the population. The potential to reduce the risk and progression of atherothrombotic heart disease is still a matter of debate.

Essential Fatty Acids as Biomedicines in Cardiac Health

“…For example, long-chain ω-3 polyunsaturated fatty acids (VLCM ω-3 PUFAs) were reported in several studies, including human trials, for their potent TG-reducing ability, which may be regarded as a crucial pathway for the prevention of CVD [56]. The biological mechanism of TG reduction is ascribed to lessening hepatic synthesis and secretion [56]. Increased doses of VLCM ω-3 PUFA are suggested for patients with extremely elevated levels of TG for pancreatitis prevention [43,56].…”

“…The biological mechanism of TG reduction is ascribed to lessening hepatic synthesis and secretion [56]. Increased doses of VLCM ω-3 PUFA are suggested for patients with extremely elevated levels of TG for pancreatitis prevention [43,56]. Several studies demonstrated the ability to reducing diastolic and systolic blood pressure of these fatty acids [56].…”

“…Increased doses of VLCM ω-3 PUFA are suggested for patients with extremely elevated levels of TG for pancreatitis prevention [43,56]. Several studies demonstrated the ability to reducing diastolic and systolic blood pressure of these fatty acids [56]. Moreover, a recent trial concluded that statin therapy combined with 4 g/day of ω-3 EPA derivative (icosapent ethyl) for patients having serum TG levels of approximately 500 mg/dL showed significant reductions in ischemic event risk and cardiovascular death [44].…”

“…Recently, other studies have confirmed the protective outcomes of icosapent ethyl [43,48]. Based on a promising efficacy, the Food and Drug Administration (FDA) recently approved icosapent ethyl as a therapeutical agent to reduce CVD-associated risks [56].…”

Marine Natural Products and Coronary Artery Disease

“…However, it was also reported that ω6PUFAs at high concentrations might reduce the influence of ω3PUFAs on the cardiovascular system ( 94 ). Another finding revealed that docosahexaenoic acid and eicosapentaenoic acid administration with 1-g values might help improve metabolic disturbance ( 95 ).…”