Effects of eicosapentaenoic acid on blood pressure, cell membrane fatty acids, and intracellular sodium concentration in essential hypertension

Aging AdipoR2-deficient mice are hyperactive with enlarged brains excessively rich in saturated fatty acids

To investigate how the fatty acid composition of brain phospholipids influences brain-specific processes, we leveraged the AdipoR2 (adiponectin receptor 2) knockout mouse model in which the brain is enlarged, and cellular membranes are excessively rich in saturated fatty acids. Lipidomics analysis of brains at 2, 7, and 18 months of age showed that phosphatidylcholines, which make up about two-thirds of all cerebrum membrane lipids, contain a gross excess of saturated fatty acids in AdipoR2 knockout mice, and that this is mostly attributed to an excess palmitic acid (C16:0) at the expense of oleic acid (C18:1), consistent with a defect in fatty acid desaturation and elongation in the mutant. Specifically, there was a ~12% increase in the overall saturated fatty acid content within phosphatidylcholines and a ~30% increase in phosphatidylcholines containing two palmitic acids. Phosphatidylethanolamines, sphingomyelins, ceramides, lactosylceramides, and dihydroceramides also showed an excess of saturated fatty acids in the AdipoR2 knockout mice while nervonic acid (C24:1) was enriched at the expense of shorter saturated fatty acids in glyceroceramides. Similar defects were found in the cerebellum and myelin sheaths. Histology showed that cell density is lower in the cerebrum of AdipoR2 knockout mice, but electron microscopy did not detect reproducible defects in the ultrastructure of cerebrum neurons, though proteomics analysis showed an enrichment of electron transport chain proteins in the cerebellum. Behavioral tests showed that older (33 weeks old) AdipoR2 knockout mice are hyperactive and anxious compared to control mice of a similar age. Also, in contrast to control mice, the AdipoR2 knockout mice do not gain weight in old age but do have normal lifespans. We conclude that an excess fatty acid saturation in brain phospholipids is accompanied by hyperactivity but seems otherwise well tolerated.

Consumption of fish balls "tsumire" may help prevent liver function deterioration in aged rats

Background: Possible health benefits of fish balls tsumire consumption on human health have been deduced based on the results of our earlier study investigating tsumire consumption by young (6-weeks-old) Sprague-Dawley rats. Aim: The objectives of this study were to evaluate the effect of tsumire intake on aged rats by feeding them a diet containing 5% dried tsumire. Methods: Biomarker levels and organ weight of 80-weeks-old Sprague-Dawley rats that were fed with tsumire were examined for potential health benefits. Results: Following 84 days of administering tsumire-containing diet, we found a decrease in some liver function parameters, such as the levels of AST, ALT, ALP and LAP, in the tsumire-fed rats compared to control rats provided with normal diet. In particular, significantly reduced LDH levels were observed in the experimental group. Conclusions: The results can be extrapolated to possible beneficial effects of consumption of tsumire on human health.

Supplementation of Dihomo-γ-Linolenic Acid for Pollen-Induced Allergic Symptoms in Healthy Subjects: A Randomized, Double-Blinded, Placebo-Controlled Trial

Dihomo-γ-linolenic acid (DGLA) is an n-6 polyunsaturated fatty acid that has been shown to have anti-inflammatory and anti-allergic effects in mice and cell study. To date, however, no human intervention study has examined the effects of DGLA. Therefore, we investigated the effects of DGLA on pollen-induced allergic symptoms in healthy adults. We performed a randomized, double-blind, placebo-controlled, parallel-group study comprising healthy Japanese men and women. Each subject received four 250 mg capsules providing 314 mg DGLA/day (DGLA group, n = 18) or olive oil (placebo group, n = 15) for 15 weeks. The primary outcomes, classification of the severity of allergic rhinitis symptoms (CSARS), and the Japanese Rhino-conjunctivitis Quality of Life Questionnaire (JRQLQ) served as symptom scores during the pollen season. In the DGLA group, the cedar pollen associated symptoms of sneezing and a blocked nose in the CSARS were significantly lower than those in the placebo group (p < 0.05, p < 0.01, respectively). Significant trends were observed the symptoms of runny nose in the CSARS and total symptom score (TSS) in the JRQLQ for cedar pollen (p < 0.1). To our knowledge, this is the first study to report the effects of DGLA in humans, and the results suggest that DGLA is effective in reducing allergic symptoms caused by pollen.

Effect of local administration of eicosapentaenoic acid on the jaw-opening reflex in rats

Although eicosapentaenoic acid (EPA) application in vitro inhibits voltage-gated Na⁺ (Nav) channels in excitable tissues, the acute local effect of EPA on the jaw-opening reflex in vivo remains unknown. The aim of the present study was to determine whether local administration of EPA to adult male Wistar rats could attenuate the excitability of the jaw-opening reflex in vivo, including nociception. The jaw-opening reflex evoked by electrical stimulation of the tongue was recorded by a digastric muscle electromyogram (dEMG) in pentobarbital-anesthetized rats. The amplitude of the dEMG response was significantly increased in proportion to the electrical stimulation intensity (1×-5× threshold). At 3×, local administration of EPA dose-dependently inhibited the dEMG response, lasting 60 min, with maximum inhibition observed within approximately 10 min. The mean magnitude of dEMG signal inhibition by EPA was almost equal to that observed with a local anesthetic, 1% lidocaine, and with a half dose of lidocaine plus a half dose of EPA. These findings suggest that EPA attenuates the jaw-opening reflex, possibly by blocking Nav channels of primary nerve terminals, and strongly support the idea that EPA is a potential therapeutic agent and complementary alternative medicine for the prevention of acute trigeminal nociception.

Dietary Omega-3 Fatty Acid Intake and Mortality in CKD Population: A 1999-2014 NHANES Analysis

INTRODUCTION

High risk of early death, especially contributed to cardiovascular disease, exists in patients who have chronic kidney disease (CKD). And the burden of cardiovascular disease is able to be lightened by an increase in omega-3 polyunsaturated fatty acid (omega-3 PUFA). A diet high in omega-3 PUFA in the general population is protective, although it is inconclusive about its beneficial role in the CKD population.

METHODS

From the 1999 to 2014 National Health and Nutrition Examination Surveys (NHANES), we can collect 2,990 participants who suffered from CKD, who were classified into 4 groups: <0.86, 0.87-1.30, 1.31-1.92, and 1.93-9.65 g/day based on NHANES 24-h dietary recall questionnaire dietary omega-3 PUFA. Moreover, their mortality details were available to be obtained by linking NHANES to the National Death Index. The associations between dietary omega-3 PUFA and mortality were evaluated by constructing multivariable Cox proportional hazards models.

RESULTS

Over 8 years of a median follow-up, 864 deaths were recorded. The adjusted hazard ratios (95% confidence interval) for all-cause mortality of the diseased people with CKD in the 2nd (0.87-1.30 g/day), 3rd (0.87-1.30 g/day), and 4th (1.93-9.65 g/day) quartiles of dietary omega-3 PUFA were 0.94 (0.72, 1.23), 0.74 (0.54, 1.02), and 0.67 (0.48, 0.93), respectively, versus those with the lowest quartile of dietary omega-3 PUFA intake (<0.86 g/day) (p for trend = 0.011).

CONCLUSION

There may be a inverse relation of dietary omega-3 PUFA intake and all-cause mortality in patients with CKD. Therefore, an increase of dietary omega-3 PUFA may be encouraged to be used clinically in patients with CKD.

Association of polyunsaturated fatty acids with improved heart rate variability and cardiovascular events in patients with end-stage renal disease receiving maintenance dialysis: a systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

Apart from dietary restriction and medical therapy, the benefits of cardiovascular protection offered by polyunsaturated fatty acid (PUFA) supplements in patients with ESRD receiving maintenance dialysis remain unclear. This systematic review and meta-analysis examined the effects of PUFAs on blood pressure, heart rate (HR), HR variability (HRV), and cardiovascular disease (CVD) prognosis.

METHODS

We identified randomized controlled trials (RCTs) from Embase, PubMed (including MEDLINE), and Web of Science. We included seven RCTs that involved 724 patients with ESRD receiving dialysis and PUFA supplements.

RESULTS

The data indicated that compared with the control group, the PUFA group demonstrated decreased cardiovascular events (Peto odds ratio = 0.52, 95% confidence interval [CI] = 0.32 to 0.85, P = 0.009) and HRV (changes in the mean HR [mean difference = -2.59, 95% CI = -4.91 to -0.26, P = 0.03, I² = 0%]; mean RR interval [MD = 29.03, 95% CI = 5.43 to 52.63, P = 0.02, I² = 0%]; mean of the standard deviation of all normal RR intervals for all 5 min segments [MD = 2.73, 95% CI = 0.48 to 4.99, P = 0.02, I² = 0%], and square root of the mean of the sum of the squares of differences between adjacent intervals [MD = 2.03, 95% CI = 0.04 to 4.03, P = 0.05, I² = 0%]).

CONCLUSION

PUFA supplements appeared to improve CVD prognosis in patients receiving dialysis. Additional RCTs with longer follow-up periods need to clarify the benefits of PUFA supplements in this patient population.

Lipid metabolism research in oleaginous fungus Mortierella alpina: Current progress and future prospects

The oleaginous fungus Mortierella alpina has distinct advantages in long-chain PUFAs production, and it is the only source for dietary arachidonic acid (ARA) certificated by FDA and European Commission. This review provides an overall introduction to M. alpina, including its major research methods, key factors governing lipid biosynthesis, metabolic engineering and omics studies. Currently, the research interests in M. alpina focus on improving lipid yield and fatty acid desaturation degree by enhancing fatty acid precursors and the reducing power NADPH, and genetic manipulation on PUFAs synthetic pathways is carried to optimise fatty acid composition. Besides, multi-omics studies have been applied to elucidate the global regulatory mechanism of lipogenesis in M. alpina. However, research challenges towards achieving a lipid cell factory lie in strain breeding and cost control due to the coenocytic mycelium, long fermentation period and insufficient conversion rate from carbon to lipid. We also proposed future research goals based on a multilevel regulating strategy: obtaining ideal chassis by directional evolution and high-throughput screening; rewiring central carbon metabolism and inhibiting competitive pathways by multi-gene manipulation system to enhance carbon to lipid conversion rate; optimisation of protein function based on post-translational modification; application of dynamic fermentation strategies suitable for different fermentation phases. By reviewing the comprehensive research progress of this oleaginous fungus, we aim to further comprehend the fungal lipid metabolism and provide reference information and guidelines for the exploration of microbial oils from the perspectives of fundamental research to industrial application.

Paradigm shift: the primary function of the "Adiponectin Receptors" is to regulate cell membrane composition

The ADIPOR1 and ADIPOR2 proteins (ADIPORs) are generally considered as adiponectin receptors with anti-diabetic properties. However, studies on the yeast and C. elegans homologs of the mammalian ADIPORs, and of the ADIPORs themselves in various mammalian cell models, support an updated/different view. Based on findings in these experimental models, the ADIPORs are now emerging as evolutionarily conserved regulators of membrane homeostasis that do not require adiponectin to act as membrane fluidity sensors and regulate phospholipid composition. More specifically, membrane rigidification activates ADIPOR signaling to promote fatty acid desaturation and incorporation of polyunsaturated fatty acids into membrane phospholipids until fluidity is restored. The present review summarizes the evidence supporting this new view of the ADIPORs, and briefly examines physiological consequences.

Systematic Review of Nutrition Supplements in Chronic Kidney Diseases: A GRADE Approach

Chronic kidney disease (CKD) is cumulative worldwide and an increasing public health issue. Aside from the widely known protein restriction and medical therapy, less evident is the renal protection of nutrition supplements in CKD patients. This systematic review (SR), using a Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach, aims to summarize and quantify evidence about the prevention effects of vitamin D and analogues, omega-3 polyunsaturated fatty acid (omega-3 PUFA), dietary fiber, coenzyme Q10 (CoQ10), and biotics on CKD progression. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to examine SRs and/or meta-analysis of clinical controlled trials identified from PubMed, Embase, and the Cochrane Library. Finally, seventeen SRs were included in the qualitative analysis. The beneficial effects of these nutrition supplements in CKD patients mostly seem to be at low to very low evidence on proteinuria, kidney function, and inflammations and did not appear to improve CKD prognosis. The recommendation of nutrition supplements in CKD patients needs to discuss with physicians and consider the benefits over the adverse effects. Longer follow-up of larger randomized trials is necessary to clarify the benefits of nutrition supplements in CKD patients.

Genome analysis and pleiotropy assessment using causal networks with loss of function mutation and metabolomics

BACKGROUND

Many genome-wide association studies have detected genomic regions associated with traits, yet understanding the functional causes of association often remains elusive. Utilizing systems approaches and focusing on intermediate molecular phenotypes might facilitate biologic understanding.

RESULTS

The availability of exome sequencing of two populations of African-Americans and European-Americans from the Atherosclerosis Risk in Communities study allowed us to investigate the effects of annotated loss-of-function (LoF) mutations on 122 serum metabolites. To assess the findings, we built metabolomic causal networks for each population separately and utilized structural equation modeling. We then validated our findings with a set of independent samples. By use of methods based on concepts of Mendelian randomization of genetic variants, we showed that some of the affected metabolites are risk predictors in the causal pathway of disease. For example, LoF mutations in the gene KIAA1755 were identified to elevate the levels of eicosapentaenoate (p-value = 5E-14), an essential fatty acid clinically identified to increase essential hypertension. We showed that this gene is in the pathway to triglycerides, where both triglycerides and essential hypertension are risk factors of metabolomic disorder and heart attack. We also identified that the gene CLDN17, harboring loss-of-function mutations, had pleiotropic actions on metabolites from amino acid and lipid pathways.

CONCLUSION

Using systems biology approaches for the analysis of metabolomics and genetic data, we integrated several biological processes, which lead to findings that may functionally connect genetic variants with complex diseases.

Effect of omega-3 long-chain polyunsaturated fatty acid supplementation on heart rate: a meta-analysis of randomized controlled trials

Background

Elevated resting heart rate (HR) has emerged as a new risk factor for all-cause and cardiovascular mortality. The effect of marine-derived omega-3 long-chain polyunsaturated fatty acid (n−3 LCPUFAs) supplementation on HR was investigated as an outcome in many clinical trials. The present study was to provide an updated meta-analysis on the HR-slowing effect of n−3 LCPUFAs, and to differentiate the chronotropic effect between eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).

Methods

PubMed and Cochrane databases were searched for relevant articles examining the effects of n−3 PUFAs on HR through May 2017. A random-effects model was used to generate the pooled effect sizes and 95% confidence intervals (CIs). The pooled effect sizes were presented as weighted mean differences (WMDs).

Results

A total of 51 randomized controlled trials (RCTs) with approximately 3000 participants were included in this meta-analysis. Compared to placebo, n−3 PUFA supplementation mildly but significantly reduced HR (−2.23 bpm; 95% CI: −3.07, −1.40 bpm). Moderate evidence of heterogeneity was observed among included trials (I² = 49.1%, P heterogeneity < 0.001). When DHA and EPA were separately administered, modest HR reduction was observed in trials that supplemented with DHA (−2.47 bpm; 95% CI: −3.47, −1.46 bpm), but not in trials with EPA.

Conclusions

The present meta-analysis provides strong clinical evidence demonstrating the effect of heart rate reduction by n−3 LCPUFA supplementation. When DHA or EPA administered alone, heart rate was slowed by DHA rather than by EPA.

Eicosapentaenoic acid and docosahexaenoic acid containing supplements modulate risk factors for cardiovascular disease: a meta-analysis of randomised placebo-control human clinical trials

BACKGROUND

Over 200 clinical trials have examined the effect of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplements on risk factors associated with cardiovascular disease. However, an updated analysis of the evidence is lacking. The aim of the present meta-analysis was to quantify the effect of supplements containing EPA and DHA on risk factors for cardiovascular disease.

METHODS

An analysis was carried on 171 clinical trials with acceptable quality (Jadad score ≥3) that were identified from a comprehensive electronic search strategy of two databases (Pubmed and Cochrane Library). A random effect model was used to obtain an overall estimate on outcomes of interest. Heterogeneity between trial results was tested for using a standard chi-squared test.

RESULTS

Compared with control, EPA and DHA supplements produced significant reductions of triglycerides of 0.368 mmol L^-1 [95% confidence interval (CI) = -0.427 to -0.309], systolic blood pressure of 2.195 mmHg (95% CI = -3.172 to -1.217), diastolic blood pressure of 1.08 mmHg (95% CI = -1.716 to -0.444), heart rate of 1.37 bpm (95% CI = -2.41 to -0.325) and C-reactive protein of 0.343 mg L^-1 (95% CI = -0.454 to -0.232). This analysis indicates an increase in both low-density lipoprotein cholesterol (mean difference = 0.150 mmol L^-1 ; 95% CI = 0.058-0.243) and high-density lipoprotein cholesterol (mean difference = 0.039 mmol L^-1 ; 95% CI = 0.024-0.054). The triglyceride-lowering effect was dose-dependent.

CONCLUSIONS

The lipid-lowering, hypotensive, anti-arrhythmic and anti-inflammatory actions of EPA and DHA supplements were confirmed in this analysis of randomised placebo-control blinded clinical trials.

The balance of omega-3 polyunsaturated fatty acids for -reducing residual risks in patients with coronary artery disease

Residual risk, which cannot be prevented by statins alone, must be controlled for inhibiting the onset of coronary events. Omega-3 polyunsaturated fatty acids (PUFAs) play an important role in controlling residual risk. The Japan eicosapentaenoic acid (EPA) Lipid Intervention Study demonstrated the inhibitory effect of high-purity EPA preparations on the residual risk of cardiovascular events. Omega-3 PUFAs inhibit coronary artery disease (CAD) through various actions, including triglyceride-lowering action. Besides lipid metabolism, platelet aggregation inhibition, anti-inflammatory effects, improved vascular endothelium function, and anti-hypertensive action contribute to arteriosclerosis inhibition. Conversely, several recent studies did not demonstrate the efficacy of omega-3 PUFAs for CAD prevention. PUFAs levels may need to exceed a threshold for anti-arteriosclerotic action. The efficacy of EPA might depend on the baseline value of the EPA/arachidonic acid (AA) ratio prior to EPA administration. This baseline EPA/AA ratio value varies according to country and region as well as changes of dietary habits. More global research in this field is needed to identify an optimal omega-3 PUFAs administration strategy.

Associations of Whole Blood n-3 and n-6 Polyunsaturated Fatty Acids with Blood Pressure in Children and Adolescents - Results from the IDEFICS/I.Family Cohort

Background

Polyunsaturated n-3 and n-6 polyunsaturated fatty acids (PUFA) are precursors of biologically active metabolites that affect blood pressure (BP) regulation. This study investigated the association of n-3 and n-6 PUFA and BP in children and adolescents.

Methods

In a subsample of 1267 children aged 2–9 years at baseline of the European IDEFICS (Identification and prevention of dietary- and lifestyle-induced health effects in children and infants) cohort whole blood fatty acids were measured by a validated gas chromatographic method. Systolic and diastolic BP was measured at baseline and after two and six years. Mixed-effects models were used to assess the associations between fatty acids at baseline and BP z-scores over time adjusting for relevant covariables. Models were further estimated stratified by sex and weight status.

Results

The baseline level of arachidonic acid was positively associated with subsequent systolic BP (β = 0.08, P = 0.002) and diastolic BP (β = 0.07, P<0.001). In thin/normal weight children, baseline alpha-linolenic (β = -1.13, P = 0.003) and eicosapentaenoic acid (β = -0.85, P = 0.003) levels were inversely related to baseline and also to subsequent systolic BP and alpha-linolenic acid to subsequent diastolic BP. In overweight/obese children, baseline eicosapentaenoic acid level was positively associated with baseline diastolic BP (β = 0.54, P = 0.005).

Conclusions

Low blood arachidonic acid levels in the whole sample and high n-3 PUFA levels in thin/normal weight children are associated with lower and therefore healthier BP. The beneficial effects of high n-3 PUFA on BP were not observed in overweight/obese children, suggesting that they may have been overlaid by the unfavorable effects of excess weight.

Antihypertensive effects of foods

Hypertension is one of the major risk factors for arteriosclerosis, which leads to cardiovascular disease and stroke. Several clinical trials revealed that control of the blood pressure is useful to reduce the morbidity and mortality associated with these diseases. However, the protective efficacy against these complications still remains at less than 50% even if the high blood pressure is treated by current medical drugs. Healthy diets are expected to not only prevent but also treat lifestyle-related diseases. Improvement of the dietary life, including low-salt diets, appropriate alcohol consumption, and calorie restriction, is important for the prevention of hypertension. In addition, green tea, which has been drunk on a daily basis in Japan and China since ancient times, possesses an antihypertensive effect, and it was revealed that its components with this effect are catechins. Many studies have been performed on the antihypertensive effects of foods. Therefore, functional foods and their ingredients, reported to possess antihypertensive effects in animal experiments and human clinical trials, are summarized in this review. Blood pressure might be controlled by improvement of the daily eating habits based on evidence regarding these functional foods, and a healthy longevity can be expected.

Effect of eicosapentaenoic acid on cholesterol gallstone formation in C57BL/6J mice

The present study investigated the preventive effect of ω-3 fatty acids against cholesterol gallstone (CG) formation. CG formation was induced in C57BL/6J mice using a lithogenic diet (LD). The mice were divided into four treatment groups: i) LD, ii) LD plus eicosapentaenoic acid (EPA), iii) LD plus docosahexaenoic acid (DHA) and iv) LD plus EPA plus DHA. Subsequent to feeding the mice the LD for four weeks, EPA and/or DHA (70 mg/kg/day) were orally administered for eight weeks. The mice in the EPA treatment groups exhibited significantly less gallstone formation than those in the LD group. By contrast, DHA treatment only slightly suppressed gallstone formation. The expression of mucin 2, 5AC, 5B and 6 was significantly decreased in the gallbladders of mice in the EPA groups (70-90%) and the LD plus DHA group (30-50%), compared with that in the mice in the LD group. In addition, the mRNA expression of 3-hydroxy-3-methylglutaryl-coenzyme A reductase was significantly decreased in the livers of mice in the EPA treatment group compared with that in the livers of mice in the LD group. In conclusion, EPA was found to have a dominant anti-lithogenic effect in C57BL/6J mice.

Metabolic engineering of microorganisms to produce omega-3 very long-chain polyunsaturated fatty acids

Omega-3 long-chain polyunsaturated fatty acids (LC-PUFAs) have received growing attention due to their significant roles in human health. Currently the main source of these nutritionally and medically important fatty acids is marine fish, which has not met ever-increasing global demand. Microorganisms are an important alternative source also being explored. Although many microorganisms accumulate omega-3 LC-PUFAs naturally, metabolic engineering might still be necessary for significantly improving their yields. Here, we review recent research involving the engineering of microorganisms for production of omega-3 LC-PUFAs, including eicospentaenoic acid and docosohexaenoic acid. Both reconstitution of omega-3 LC-PUFA biosynthetic pathways and modification of existing pathways in microorganisms have demonstrated the potential to produce high levels of omega-3 LC-PUFAs. However, the yields of omega-3 LC-PUFAs in host systems have been substantially limited by potential metabolic bottlenecks, which might be caused partly by inefficient flux of fatty acid intermediates between the acyl-CoA and different lipid class pools. Although fatty acid flux in both native and heterologous microbial hosts might be controlled by several acyltransferases, evidence has suggested that genetic manipulation of one acyltransferase alone could significantly increase the accumulation of LC-PUFAs. The number of oleaginous microorganisms that can be genetically transformed is increasing, which will advance engineering efforts to maximize LC-PUFA yields in microbial strains.

A randomized placebo-controlled trial of an omega-3 fatty acid and vitamins E+C in schizophrenia

Membrane lipid metabolism and redox regulation may be disturbed in schizophrenia. We examined the clinical effect of adding an omega-3 fatty acid and/or vitamins E+C to antipsychotics. It was hypothesized that lower baseline levels of polyunsaturated fatty acids (PUFAs) would predict more benefit from the add-on treatment. The trial had a multicenter, randomized, double-blind, placebo-controlled 2 × 2 factorial design. Patients aged 18-39 years with schizophrenia or related psychoses were consecutively included at admission to psychiatric departments in Norway. They received active or placebo ethyl-eicosapentaenoate (EPA) 2 g day⁻¹ and active or placebo vitamin E 364 mg day⁻¹+vitamin C 1000 mg day⁻¹ (vitamins) for 16 weeks. The main outcome measures were Positive and Negative Syndrome Scale (PANSS) total and subscales scores, analyzed by linear mixed models. Ninety-nine patients were included. At baseline, erythrocyte PUFA were measured in 97 subjects. Given separately, EPA and vitamins increased drop-out rates, whereas when combined they did not differ from placebo. In low PUFA patients, EPA alone impaired the course of total PANSS (Cohen's d=0.29; P=0.03) and psychotic symptoms (d=0.40; P=0.003), especially persecutory delusions (d=0.48; P=0.0004). Vitamins alone impaired the course of psychotic symptoms (d= 0.37; P=0.005), especially persecutory delusions (d=0.47; P=0.0005). Adding vitamins to EPA neutralized the detrimental effect on psychosis (interaction d=0.31; P=0.02). In high PUFA patients, there were no significant effects of trial drugs on PANSS scales. In conclusion, given separately during an acute episode, EPA and vitamins E+C induce psychotic symptoms in patients with low levels of PUFA. Combined, these agents seem safe.

Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients

BACKGROUND

Unlike the n-6 polyunsaturated fatty acid (PUFA) arachidonic acid (AA), n-3-PUFAs such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) appear to have beneficial effects on inflammation, thrombosis, and cardiovascular disease (CVD). We examined possible alterations in serum PUFA profiles in patients on maintenance hemodialysis therapy and its association with CVD risk.

STUDY DESIGN

An observational study including cross-sectional and longitudinal analyses.

SETTING & PARTICIPANTS

Single-center study of 517 maintenance hemodialysis patients in an urban area in Japan.

PREDICTORS

Serum EPA, DHA, and AA concentrations and EPA:AA, DHA:AA, and (EPA+DHA):AA ratios.

OUTCOMES

CVD events, including ischemic heart disease, stroke, peripheral artery disease, pulmonary edema, and valve disease.

RESULTS

Hemodialysis patients showed lower (EPA+DHA):AA, EPA:AA, and DHA:AA ratios than 122 controls similar in age and sex. During follow-up, 190 CVD events were recorded. (EPA+DHA):AA ratio was not associated significantly with CVD in unadjusted analysis, but was associated significantly and inversely with CVD in Cox models adjusted for age and other confounding variables, with HRs in the range of 1.71-1.99 in the lowest versus highest quartile of (EPA+DHA):AA ratios. Similarly, EPA:AA and DHA:AA ratios showed inverse associations with CVD, whereas serum EPA, DHA, and AA concentrations were not predictive of CVD.

LIMITATIONS

No information for dietary intake, use of dietary supplements, or cell membrane PUFA content.

CONCLUSIONS

In hemodialysis patients, serum PUFA profile is unfavorably altered, and the low n-3-PUFA:AA ratios are independent predictors of CVD.

Effect of eicosapentaenoic acid on central systolic blood pressure

Central systolic blood pressure (C-SBP) has been shown to be a better predictor of cardiovascular risk than brachial SBP. In this study, the effects of eicosapentaenoic acid (EPA) on C-SBP were compared with pravastatin. Twenty-four patients with hyperlipidemia were assigned 13 to receive 1800 mg/day EPA (EPA group) and 11 to receive 10 mg/day pravastatin (pravastatin group) for 3 months. In the EPA group, there were no changes in the LDL-cholesterol level. However, the radial augmentation index (AI) and C-SBP decreased after treatment by 5.7% (p < 0.01) and 8.7% (p < 0.001), respectively. Moreover, systolic and diastolic brachial BPs decreased by 7.1% and 8.0%, respectively (p < 0.01 for both). In the pravastatin group, the LDL-cholesterol level decreased by 29.5% (p < 0.001). However, there were no significant changes in brachial BP, AI and C-SBP between. These results suggested that EPA but not pravastatin may reduce cardiac afterload by reducing vascular reflected waves and lowering C-SBP.

Effect of evening primrose oil and ω-3 polyunsaturated fatty acids on the cardiovascular risk of celecoxib in rats

Experimental data raised the specter of increased cardiovascular risk with selective cyclooxygenase-2 inhibitors. The study aimed to investigate the cardiovascular risk caused by celecoxib by studying its effect on blood pressure (BP) and thrombogenesis in rats. We tested the possible protective effects of evening primrose oil (EPO) or ω-3 polyunsaturated fatty acids (n-3 PUFAs). Male Wistar rats were assigned to the following groups: vehicle, celecoxib, celecoxib/n-3 PUFAs, celecoxib/EPO, n-3 PUFAs, and EPO. The rats were treated with celecoxib (20 mg·kg(-1)·d(-1)) by gastric gavage for 6 weeks. The mean BP was recorded, and blood samples were collected for testing prothrombin time and activated partial thromboplastin time. Platelet aggregation assay and collagen-induced platelet consumption test were used as models of thrombogenesis. Celecoxib increased the BP without affecting coagulation parameters and accelerated thrombogenesis by increasing platelet aggregation and collagen-induced thrombocytopenia. EPO and n-3 PUFAs decreased the celecoxib-induced elevation in BP. Although EPO significantly decreased platelet aggregation and collagen-induced thrombocytopenia, n-3 PUFAs did not. Celecoxib elevated BP and increased the risk of thrombogenesis in rats. A combination of celecoxib and the selected natural supplements is suggested as a novel approach to minimize cardiovascular risk caused by celecoxib.

Dietary intake of stearidonic acid-enriched soybean oil increases the omega-3 index: randomized, double-blind clinical study of efficacy and safety

BACKGROUND

The benefits of omega-3 (n-3) long-chain polyunsaturated fatty acids to heart health are well established. Stearidonic acid (SDA, 18:4n-3) may contribute to these benefits.

OBJECTIVE

The objective was to evaluate the ability of SDA-containing soybean oil to increase the omega-3 index [erythrocyte eicosapentaenoic acid (EPA) + docosahexaenoic acid, as a percentage of total fatty acids] and to affect other cardiovascular disease risk markers compared with EPA and regular soy oil (control).

DESIGN

This was a randomized, placebo-controlled, double-blind multicenter study in which 252 overweight subjects were randomly assigned to 1 of 3 treatments for 12 wk: 1 g encapsulated soybean oil/d plus 14.7 g liquid soybean oil/d to be mixed in food (control group), 1 g encapsulated EPA/d plus 14.7 g liquid soybean oil/d (EPA group), and 1 g encapsulated soybean oil/d plus 14.7 g liquid SDA-enriched soybean oil/d, providing 4.2 g SDA (SDA group). Subjects consumed treatment oils in exchange for other oils in their diet.

RESULTS

The mean (±SE) baseline omega-3 index was similar between treatments, but after 12 wk of treatment values for this index were 4.15 ± 0.12%, 4.84 ± 0.13%, and 4.69 ± 0.15% for control, EPA, and SDA groups, respectively. Values for the EPA and SDA groups were greater than those for control subjects in the intent-to-treat population (P < 0.001 and P = 0.006, respectively). No adverse treatment-related effects of SDA-enriched soybean oil were reported.

CONCLUSIONS

SDA-enriched soybean oil increased the omega-3 index by raising erythrocyte EPA concentrations. SDA-enriched soybean oil is a land-based n-3 fatty acid that is a sustainable approach to increasing tissue concentrations of long-chain polyunsaturated n-3 fatty acids.

Anti-hypertensive nutraceuticals and functional foods

Epidemiological studies have demonstrated that elevated blood pressure is one of the major risk factors for stroke and coronary heart disease (CHD). A close association between blood pressure and the incidence of cardiovascular diseases is well established if systolic/diastolic blood pressure is above 140/90 mmHg. In recent years, nutraceuticals and functional foods have attracted considerable interest as potential alternative therapies for treatment of hypertension, especially for prehypertensive patients, whose blood pressure is marginally or mildly high but not high enough to warrant the prescription of blood pressure-lowering medications. This review summarizes the findings of recent studies on the chemistry, production, application, efficacy, and mechanisms of popular blood pressure-lowering nutraceuticals and functional foods including the Dietary Approaches to Stop Hypertension (DASH) diet plan, L-arginine, chlorogenic acid, fermented milk, garlic, onion, tea, soybean, ginger, hawthorn, and fish oil.

Castration modifies aortic vasoreactivity and serum fatty acids in a sucrose-fed rat model of metabolic syndrome

Levels of testosterone and estradiol influence the incidence of cardiovascular diseases: generally, estrogens in females are protective before menopause; coronaropathies, hypertension, and dyslipidemias in normal men are more frequent at comparable ages. We investigated the modulation by castration of in vitro vasoreactivity, serum lipid content, and systolic blood pressure (SBP) in rats with sucrose-induced metabolic syndrome. The main characteristics of the rat model are: hypertriglyceridemia, moderately high blood pressure, intra-abdominal accumulation of adipose tissue, hyperinsulinemia, nephropathy, increased oxidative stress, and altered vasoreactivity. Male weanling rats received 30% sucrose solution for 16 weeks (metabolic syndrome; MS), controls (C) had plain water; both had commercial rodent chow. They were subdivided into five groups with two subgroups each: Group 1, intact C and MS rats, Groups 2-5, C and MS rats castrated for periods of 16, 12, 8, and 4 weeks. At the end of the study period, systolic blood pressure was measured, and blood and aortas were obtained for fatty acid determination and vasoreactivity assays, respectively. After 16 weeks' sucrose treatment MS aortas showed hypercontractility and decreased vasodilation. Palmitic and palmitoleic acids were increased in MS versus C. Arachidonic acid levels in MS were lower than in intact or castrated C. Long-term castration of 16 weeks normalized the levels of palmitic and oleic acids. With the shorter periods of castration, contractility increased and relaxation decreased in C and MS, but it was more significant in C. Regarding fatty acid composition, long-term castration increased polyunsaturated (arachidonic and eicosapentaenoic) fatty acids. The shorter periods did not modify the fatty acid profile in either C or MS. Metabolic syndrome altered SBP, aortic reactivity, and levels of fatty acids; castration of long duration normalized them in some cases.

Fasting serum free fatty acid composition, waist/hip ratio and insulin activity in essential hypertensive patients

Abnormal fatty acid metabolism may play an important role in the pathogenesis of essential hypertension (EH). We compared fasting serum free fatty acid (FFA) composition between EH patients and nonhypertensive (NH) subjects, and examined the relationships between fasting serum FFA composition and waist/hip ratio, insulin activity, blood pressure, serum zinc, age, and sex in both groups. We conducted a cross-sectional study of 232 community-dwelling subjects aged between 35 and 60 years: 109 EH patients and 123 NH subjects. Serum FFA was determined by HPLC analysis. The data were analyzed by multivariate linear stepwise regression, stratified analysis, and correlation analysis. In men, EH patients had lower C22:6/C20:5 ratios (n-3 Delta6-desaturase activity index, 7.96+/-8.81 vs. 14.5+/-13.1, p<0.01), polyunsaturated fatty acid (PUFA), n-3 PUFA and polyunsaturated/saturated (P/S) ratios compared with male subjects without hypertension. There were no differences in women. Fasting serum FFA composition was significantly related to many variables, including waist/hip ratio, insulin sensitivity index, and serum zinc (all p<0.05 or <0.01) for all the subjects, and included both age- and sex-related differences (both p<0.05). Compared with NH, EH patients had lower levels of serum zinc (14.9+/-5.00 micromol L(-1) vs. 16.8+/-6.38 micromol L(-1), p<0.05). We concluded that EH patients had marked alteration in fasting serum FFA composition, which was affected by upper body obesity, insulin resistance, zinc deficiency, and high dietary fat, and that the differences were age- and sex-related.

Fish oil supplementation improves large arterial elasticity in overweight hypertensive patients

OBJECTIVES

To observe the effect of fish oil supplementation on arterial elasticity and blood pressure (BP) in overweight hypertensive patients.

SUBJECTS AND METHODS

This was a double-blind, randomized and placebo-controlled clinical study, in which 52 overweight hypertensive patients from a community were selected and randomly allocated to two groups (26 in the fish oil group (3 g day(-1), fish oil capsules) and 26 in the placebo group (only capsules). All the subjects were follow-up for 8 weeks. The arterial elasticity was determined by CVProfilor DO-2020 and expressed as elasticity indexes (C(1)-large artery and C(2)-small artery). During the follow-up, totally nine cases were dropped out (three cases from the fish oil group and six cases from the placebo group).

RESULTS

After 8 weeks follow-up, the large artery elasticity in the fish oil group, compared with its baseline, was significantly improved (C(1): 15.5+/-1.5 vs 12.8+/-3.7 ml mm Hg(-1) x 10), whereas no effects were found in the placebo group (C(1): 13.0+/-3.4 vs 13.4+/-3.8 ml mm Hg(-1) x 10), P=0.027, RM-ANOVA across the two groups. The small artery elasticity (C(2)), BP and pulse pressure were not found any changes, either in the fish oil group or in the placebo group. At same time, the serum soluble vascular cell adhesion molecule-1(sVCAM-1) and leptin levels, the lipid profile and insulin sensitivity index (ISI) as well, did not show significant differences between two groups.

CONCLUSIONS

Fish oil supplementation certainly would improve large arterial elasticity but no effect on BP in overweight hypertensive patients. Further study is needed to confirm the benefits of fish oil supplementation on age-related increases in arterial stiffness.

Inhibitory effect of insulin on vasopressin-induced intracellular calcium response is blunted in hyperinsulinemic hypertensive patients: role of membrane fatty acid composition

Impaired insulin-mediated vasodilation has been implicated in hypertension that is associated with the metabolic syndrome. The aim of this study was to determine whether an abnormality in membrane fatty acid composition was related to a weakening of insulin's inhibitory effect on agonist-stimulated intracellular free calcium elevation. Mild to moderate hypertensive patients (n = 27) and normotensive controls (n = 11) were studied. Hypertensive patients were divided into normoinsulinemic patients (n = 14) and hyperinsulinemic patients (n = 13) according to the area under the curve of plasma insulin concentrations during a 75-g oral glucose tolerance test. Nonstimulated and arginine-vasopressin (AVP) (1 micromol/l)-stimulated intraplatelet free calcium concentrations (p[Ca(2+)](i)) were measured with or without insulin (100 microU/ml) preincubation. Platelet membrane fatty acid composition, intraerythrocyte sodium content, and the ouabain-sensitive sodium efflux rate constant (K (os)) of erythrocytes were also determined. Insulin preincubation reduced AVP-stimulated p[Ca(2+)](i) elevation in both normotensive controls and hypertensive patients. The inhibitory effect of insulin on AVP-stimulated elevation of p[Ca(2+)](i) (%Inhibition) was significantly (P < 0.05) blunted in hyperinsulinemic hypertensive patients (9.7% +/- 2.4%) as compared to normoinsulinemic hypertensive patients (17.4% +/- 2.7%) and normotensive controls (16.9% +/- 1.7%). In hypertensive patients, the %Inhibition was correlated negatively with saturated fatty acids (SFA) (r = -0.51, P < 0.05) and systolic blood pressure (r = -0.44, P < 0.05), and correlated positively with membrane polyunsaturated fatty acids (PUFA) (r = 0.53, P < 0.01) and K (os) (r = 0.53, P < 0.005). Multiple regression analysis showed that SFA, PUFA, and K (os) were the significant variables for %Inhibition. These findings indicate that an increase in SFA and a decrease in PUFA may cause insulin insensitivity in cellular calcium and sodium handling in hypertension with hyperinsulinemia.

Effect of Fish Oil on Heart Rate in Humans

Background— The effect of fish oil on heart rate (HR), a major risk factor for sudden death, is not well established. We calculated this effect in a meta-analysis of randomized, double-blind, placebo-controlled trials in humans.

Methods and Results— Randomized trials of fish oil that evaluated HR were identified through MEDLINE (1966 through January 2005), hand-searching of references, and contact with investigators for unpublished results. Two investigators independently extracted trial data. A pooled estimate was calculated from random-effects meta-analysis. Predefined stratified meta-analyses and meta-regression were used to explore potential heterogeneity. Of 197 identified articles, 30 met inclusion criteria. Evidence for publication bias was not present. In the overall pooled estimate, fish oil decreased HR by 1.6 bpm (95% CI, 0.6 to 2.5; P =0.002) compared with placebo. Between-trial heterogeneity was evident (Q test, P <0.001). Fish oil reduced HR by 2.5 bpm ( P <0.001) in trials with baseline HR ≥69 bpm (median) but had little effect (0.04-bpm reduction; P =0.56) in trials with baseline HR <69 bpm ( P for interaction=0.03). Fish oil reduced HR by 2.5 bpm ( P <0.001) in trials with duration ≥12 weeks but had less effect (0.7-bpm reduction; P =0.27) in trials with duration <12 weeks ( P for interaction=0.07). HR reduction with fish oil intake did not significantly vary by fish oil dose (range, 0.81 to 15 g/d), type of HR measure, population age, population health, parallel versus crossover design, type of control oil, or study quality by Delphi criteria ( P for interaction >0.25 for each).

Conclusions— In randomized controlled trials in humans, fish oil reduces HR, particularly in those with higher baseline HR or longer treatment duration. These findings provide firm evidence that fish oil consumption directly or indirectly affects cardiac electrophysiology in humans. Potential mechanisms such as effects on the sinus node, ventricular efficiency, or autonomic function deserve further investigation.

Modulation of epithelial Na+ channel activity by long-chain n-3 fatty acids

The epithelial sodium channel is found in apical membranes of a variety of native epithelial tissues, where it regulates sodium and fluid balance. In vivo, a number of hormones and other endogenous factors, including polyunsaturated fatty acids (PUFAs), regulate these channels. We tested the effects of essential n-3 and n-6 PUFAs on amiloride-sensitive sodium transport in A6 epithelial cells. Eicosapentaenoic acid [EPA; C20:5(n-3)] transiently stimulated amiloride-sensitive open-circuit current (I(Na)) from 4.0 +/- 0.3 to 7.7 +/- 0.3 microA/cm2 within 30 min (P < 0.001). No activation was seen in the presence of 10 microM amiloride. In cell-attached but not in cell-excised patches, EPA acutely increased the open probability of sodium channels from 0.45 +/- 0.08 to 0.63 +/- 0.10 (P = 0.02, paired t-test). n-6 PUFAs, including linoleic acid (C18:2), eicosatetraynoic acid (C20:4), and docosapentanoic acid (C22:5) had no effect, whereas n-3 docosahexanoic acid (C22:6) activated amiloride-sensitive I(Na) in a manner similar to EPA. Activation of I(Na) by EPA was prevented by H-89, a PKA inhibitor. Similarly, PKA activity was stimulated by EPA. Nonspecific stimulation of phosphodiesterase activity by CoCl2 completely prevented the effect of EPA on sodium transport. We conclude that n-3 PUFAs activate epithelial sodium channels downstream of cAMP in a cAMP-dependent pathway also involving PKA.

Bezafibrate improves hypertension and insulin sensitivity in humans

We examined cellular membrane fatty acid composition and insulin sensitivity in patients with mild essential hypertension and hyperlipidemia, and investigated whether bezafibrate, a lipid-lowering drug, could improve elevated blood pressure and insulin sensitivity in these subjects by ameliorating cellular membrane fatty acid composition. Twenty-seven subjects were recruited. Twelve men with mild essential hypertension [systolic blood pressure (SBP) between 140 mmHg and 160 mmHg] and hypertriglyceridemia (plasma triglyceride concentration over 150 mg/dl) were designated the HL group. Fifteen men with mild essential hypertension and normotriglyceridemia (plasma triglyceride concentration below 150 mg/dl) were designated the NL group. Subjects in the HL group were given bezafibrate 400 mg/dl and those in the NL group were given placebo for 3 months. Bezafibrate significantly reduced SBP (140 +/- 2.6 to 131.8 +/- 2.6 mmHg, mean +/- SEM), diastolic blood pressure (DBP) (87.8 +/- 2.0 to 82.8 +/- 2.6 mmHg), fasting plasma triglyceride concentration (225.5 +/- 23.5 to 102.9 +/- 10.9 mg/dl), fasting plasma insulin concentration (9.6 +/- 0.8 to 7.1 +/- 0.8 microU/ml), and homeostasis model assessment scores (HOMA-R, 2.4 +/- 0.2 to 1.7 +/- 0.2), and significantly improved the insulin sensitivity index (56.0 +/- 3.0 to 70.7 +/- 4.8 mg x l2/mmol x mU x min) in the HL group. Regarding erythrocyte membrane fatty acid composition, bezafibrate reduced the percentages of saturated fatty acids (SFA) and increased the percentage of polyunsaturated fatty acids (PUFA). Plasma triglyceride concentrations were positively correlated with HOMA-R (r = 0.50, p < 0.01) and SFA (r = 0.39, p < 0.05), and negatively correlated with PUFA (r = -0.45, p < 0.05) before administration of placebo or bezafibrate. In conclusion, an improvement of hyperlipidemia by bezafibrate may be attributed to reduction of blood pressure and amelioration of insulin sensitivity. Abnormalities in membrane lipid composition may play an important role in these metabolic disorders.

Relationship of urinary sodium/potassium excretion and calcium intake to blood pressure and prevalence of hypertension among older Chinese vegetarians

OBJECTIVE

To examine the associations of dietary sodium and potassium, as reflected by the urinary sodium/potassium excretion, and calcium intake with blood pressure and the prevalence of hypertension among older Chinese vegetarians in Hong Kong.

DESIGN

Cross-sectional study.

SETTING

Research clinic in a teaching hospital in Hong Kong.

SUBJECTS

A total of 111 ambulatory vegetarians over the age of 55 were recruited from members of religious organizations or old age hostels.

MAIN OUTCOME MEASURES

Hypertension was defined as supine blood pressure >140/90 mmHg or a history of hypertension. Dietary sodium, potassium and calcium intakes were assessed by 24 h recall method or fasting urinary sodium or potassium/creatinine ratios.

RESULTS

Seventy-one subjects (64%) were found to have hypertension. Compared with normotensive subjects, hypertensive subjects had lower calcium intake (411+/-s.d. 324 vs 589+/-428 mg, P=0.04), but higher urinary sodium/creatinine ratio (32.6+/-19.3 vs 21.0+/-12.4, P=0.00) and sodium/potassium ratio (4.7+/-2.8 vs 3.4+/-2.3, P=0.02). Among 88 subjects not taking diuretics or antihypertensive drugs, systolic blood pressure was related to calcium intake (r=-0.40), urinary sodium/creatinine ratio (r=0.39), urinary sodium/potassium ratio (r=0.30) and age (r=0.23). Diastolic blood pressure was related to urinary sodium/creatinine (r=0.29). Twenty-three subjects with high urinary sodium/potassium and low calcium intake and 16 subjects with low urinary sodium/potassium ratio and high calcium intake differed markedly with respect to systolic blood pressure (159+/-26 vs 130+/-15 mmHg) and prevalence of hypertension (78% vs 25%).

CONCLUSIONS

Older Chinese vegetarians are predisposed to hypertension because of their sodium-rich but calcium-deficient diets.

Eicosapentaenoic Acid Suppresses Basal and Insulin-Stimulated Endothelin-1 Production in Human Endothelial Cells

cis-Polyunsaturated fatty acids such as eicosapentaenoic acid (EPA) are the major fatty acids contained in fish oil, and are known to affect the various physiological properties of cell membranes in humans. The present study investigated the effects of polyunsaturated fatty acids on endothelin-1 (ET-1) production in human umbilical vein endothelial cells (HUVECs) and on insulin activity. After addition of various concentrations of EPA, docosahexaenoic acid, arachidonic acid, or linoleic acid to a culture medium, the concentration of ET-1 was measured using ELISA, and that of ET-1 mRNA was determined by RT-PCR. The results showed that EPA had the strongest inhibitory effect (p<0.05) on both basal ET-1 production and ET-1 mRNA levels. In addition, insulin (1 micromol/l) markedly increased ET-1 production, and EPA also significantly decreased the effect induced by insulin. Pretreatment with Ca2+ chelator EGTA (1 mmol/l), NOS inhibitor L-NAME (300 micromol/l), or calmodulin antagonist W-7 (300 micromol/l) inhibited NO production by EPA (100 micromol/l), but these pretreatments had no effect on ET-1 production by EPA. These findings suggest that EPA reduces basal and insulin-enhanced ET-1 production by inhibiting ET-1 mRNA production. These effects of EPA may contribute to its vasorelaxant and anti-atherosclerotic effects.

Troglitazone reduces activity of the Na+/H+ exchanger in fructose-fed borderline hypertensive rats

Activation of the Na+/H+ exchanger (NHE) is known to be related to elevated blood pressure in hyperinsulinemia. We previously demonstrated that a fructose-enriched diet induced hyperinsulinemia and hypertriglyceridemia, elevated NHE activity, increased intracellular calcium concentrations ([Ca2+]i), and increased blood pressure in borderline hypertensive rats (BHR). This study examines whether pharmacologically reducing plasma triglyceride or insulin concentrations lowers blood pressure and reduces NHE activity in fructose-fed BHR. Eicosapentaenoic acid (EPA), bezafibrate (BEZ), and troglitazone (TRO) were administered to treat hypertriglyceridemia and/or hyperinsulinemia. Rats were fed a 60% fructose diet or a control diet for 4 weeks, followed by a diet with either vehicle, EPA, BEZ, or TRO for 4 weeks. Intracellular pH (pHi) was measured in platelets by fluorescent dye. Platelet NHE activity was evaluated by the recovery of pHi following addition of sodium propionate (Vmax). [Ca2+]i in platelets were measured fluorometrically. In fructose-fed rats, EPA prevented further increase in blood pressure, and reduced triglyceride concentration and [Ca2+]i without affecting Vmax or plasma insulin concentrations. BEZ reduced triglyceride concentrations without affecting blood pressure, Vmax, [Ca2+]i, or insulin concentrations. TRO prevented an increase in blood pressure, and reduced Vmax, [Ca2+]i, and insulin, but not triglycerides. Plasma insulin and Vmax were positively correlated. In conclusion, improvement of hyperinsulinemia can decrease NHE activity and blood pressure in fructose-fed BHR.

Eicosapentaenoic acid improves endothelial function in hypertriglyceridemic subjects despite increased lipid oxidizability

BACKGROUND

Epidemiologic investigations suggest that fish oil, which contains eicosapentaenoic acid (EPA), has favorable cardiovascular effects. Fish oil improves endothelial function in subjects with hypercholesterolemia or diabetes. However, controversy persists regarding relationships between primary hypertriglyceridemia and endothelial dysfunction. Moreover, lipoproteins are more susceptible to oxidation in vitro after incorporation of fish oil.

METHODS

We determined the effects of EPA on serum lipids, susceptibility of low-density lipoproteins (LDL) and very-low-density lipoproteins (VLDL) to oxidation, and endothelial function in hypertriglyceridemic (HTG) subjects. In 8 men with untreated primary hypertriglyceridemia (plasma triglyceride between 150 and 500 mg/dL) and 7 control subjects (triglyceride below 150 mg/dL), forearm blood flow (FBF) responses were tested. In HTG subjects, this was repeated 3 months after initiation of EPA (1800 mg/day). Cu2+-induced oxidation of VLDL and LDL was determined by serial measurement of conjugated dienes. We used lag time, which corresponded to the period when the lipoproteins were resistant to oxidation, as a parameter of oxidizability. FBF responses to acetylcholine and sodium nitroprusside were determined by strain-gauge plethysmography.

RESULTS

Plasma triglyceride in HTG subjects fell 31% with EPA supplementation. Before EPA, VLDL and LDL lag times in HTG subjects were shorter than in control subjects. EPA further reduced lag time for VLDL but not LDL. The FBF response to acetylcholine (but not to nitroprusside) was significantly less in HTG subjects before EPA than in control subjects. EPA normalized the FBF response to acetylcholine.

CONCLUSIONS

EPA improves endothelial function in HTG subjects despite increasing in VLDL oxidizability.