(Circulation. 2000;102:1264.)
© 2000 American Heart Association, Inc.
Clinical Investigation and Reports |
From the Department of Medicine, University of Western Australia, and The West Australian Heart Research Institute, Perth, Australia.
Correspondence to Dr Trevor A Mori, University Department of Medicine, Box X2213 GPO, Perth, Western Australia 6847, Australia. E-mail tmori{at}cyllene.uwa.edu.au
BackgroundRecent evidence
supports differential effects of
eicosapentaenoic acid (EPA) and docosahexaenoic
acid (DHA), the 2 major
3 fatty acids of marine origin, on blood
pressure in humans and vascular reactivity in adult
spontaneously hypertensive rats. We investigated possible differences
in the effects of purified EPA or DHA on forearm vascular reactivity in
overweight hyperlipidemic men that might contribute to
the blood pressurelowering effects of fish oils.
Methods and ResultsWith a double-blind, placebo-controlled trial of parallel design, 59 overweight, mildly hyperlipidemic men were randomized to receive 4 g/d purified EPA, DHA, or olive oil (placebo) capsules while continuing their usual diets for 6 weeks. Forearm blood flow (FBF) was measured with venous occlusion, strain-gauge plethysmography during the sequential intra-arterial administration of acetylcholine (7.5, 15, and 30 µg/min), sodium nitroprusside (1.5, 3, and 10 µg/min), norepinephrine (10, 20, and 40 ng/min), a single-dose infusion of NG-monomethyl-L-arginine (L-NMMA) (1 mg/min), and coinfusion of acetylcholine (7.5, 15, and 30 µg/min) and L-NMMA. Forty of the 56 subjects who completed the study underwent FBF measurements. Plasma phospholipid EPA levels increased significantly (P<0.0001) after supplementation with EPA, and DHA composition increased with DHA supplementation (P<0.0001). Relative to placebo, DHA, but not EPA, supplementation significantly improved FBF in response to acetylcholine infusion (P=0.040) and coinfusion of acetylcholine with L-NMMA (P=0.040). Infusion of L-NMMA alone showed no group differences. DHA significantly enhanced dilatory responses to sodium nitroprusside (P<0.0001) and attenuated constrictor responses to norepinephrine (P=0.017).
ConclusionsRelative to placebo, DHA, but not EPA, enhances vasodilator mechanisms and attenuates constrictor responses in the forearm microcirculation. Improvements in endothelium-independent mechanisms appear to be predominant and may contribute to the selective blood pressurelowering effect observed with DHA compared with EPA in humans.
Key Words: fish oils vasculature blood pressure nitric oxide microcirculation
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