The cardiovascular implications of omega-3 fatty acids

Cardiology Journal

Volumn 13, Issue 7, 2006, Pages 557-569

  Block, Robert C ^a   Pearson, Thomas A ^a  

^a UNIVERSITY OF ROCHESTER SCHOOL OF MEDICINE AND DENTISTRY   (United States)

Author keywords

n 6 n 3 ratio; Omacor; Omega 3 fatty acids; Omega 3 index; Omega 6 fatty acids

Indexed keywords

DIPEPTIDYL CARBOXYPEPTIDASE INHIBITOR; DOCOSAHEXAENOIC ACID; FISH OIL; HIGH DENSITY LIPOPROTEIN; ICOSAPENTAENOIC ACID; LINOLENIC ACID; LIPID; LOW DENSITY LIPOPROTEIN; MERCURY; OMEGA 3 FATTY ACID; OMEGA 6 FATTY ACID; POLYCHLORINATED BIPHENYL; TRIACYLGLYCEROL;

ANTIARRHYTHMIC ACTIVITY; ANTIINFLAMMATORY ACTIVITY; ATHEROSCLEROSIS; CARDIOVASCULAR DISEASE; CAUSE OF DEATH; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; DIET SUPPLEMENTATION; DIETARY INTAKE; DRUG BLOOD LEVEL; DRUG MEGADOSE; ENVIRONMENTAL EXPOSURE; FISH; FOOD CONTAMINATION; FOOD PREFERENCE; FOOD SAFETY; GEOGRAPHIC DISTRIBUTION; HEALTH PRACTITIONER; HEART DEATH; HEART MUSCLE COMPLIANCE; HEART MUSCLE FIBROSIS; HEART PROTECTION; HEART RATE VARIABILITY; HEART VENTRICLE ARRHYTHMIA; HEART VENTRICLE FUNCTION; HEART VENTRICLE HYPERTROPHY; HUMAN; ISCHEMIC HEART DISEASE; LIPID METABOLISM; MEDICAL DECISION MAKING; META ANALYSIS; NUTRITIONAL REQUIREMENT; OBSERVATIONAL STUDY; PRACTICE GUIDELINE; PRIMARY PREVENTION; RANDOMIZED CONTROLLED TRIAL; REVIEW; RISK REDUCTION; SECONDARY PREVENTION; SIDE EFFECT; SYSTEMATIC REVIEW; THROMBOSIS; TRIACYLGLYCEROL BLOOD LEVEL;

EID: 39149117030     PISSN: 18975593     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (87)

1. Kris-Etherton PM, Harris WS, Appel LJ. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation, 2002; 106: 2747-2757.
2. National Vital Statistics Report: Deaths: Preliminary Data for 2003 (NVSR 2005; 53: 15) 2005; 53: 15.
3. Weylandt KH, Kang JX. Rethinking lipid mediators. Lancet. 2005; 366: 618-620.
4. Burr ML, Fehily AM, Gilbert JF et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet, 1989; 2: 757-761.
5. Leigh-Firbank EC, Minhane AM, Leake DS et al. Eicosapentaenoic acid and docosahexaenoic acid from fish oils: differential associations with lipid responses. Br J Nutr, 2002; 87: 435-445.
6. Kasim-Karakas SE, Hermann R, Almario R. Effects of omega-3 fatty acids on intravascular lipolysis of very-low density lipoproteins in humans. Metabolism, 1995; 44: 1223-1230.
7. Hebbachi AM, Seelaender MC, Baker BW, Gibbons GF. Decreased secretion of very-low-density lipoprotein triacylglycerol and apolipoprotein B is associated with decreased intracellular triacylglycerol lipolysis in hepatocytes derived from rats fed orotic acid or n-3 fatty acids. Biochem, 1997; 325 (Pt. 3): 711-719.
8. Mesa MD, Buckley R, Minihane AM, Yaqoob P. Effects of oils rich in eicosapentaenoic and docosahexaenoic acids on the oxidizability and thrombogenicity of low-density lipoprotein. Atherosclerosis, 2004; 175: 333-343.
9. Higdon JV, Du SH, Lee YS, Wu T, Wander RC. Supplementation of postmenopausal women with fish oil does not increase overall oxidation of LDL ex vivo compared to dietary oils rich in oleate and linoleate. J Lipid Res, 2001; 42: 407-418.
10. Castro IA, Barroso LP, Sinnecker P. Functional foods for coronary heart disease risk reduction: a meta-analysis using a multivariate approach. Am J Clin Nutr, 2005; 82: 32-40.
11. De Caterina R, Liao JK, Libby P. Fatty acid modulation of endothelial activation. Am J Clin Nutr, 2000; 71: 213S-223S.
12. Hjerkinn EM, Seljeflot I, Ellingsen I, Berstad P, Hjermann IL, Arnesen H. Influence of long-term intervention with dietary counseling, long-chain n-3 fatty acid supplements, or both, on circulating markers of endothelial activation in men with long-standing hyperlipidemia. Am J Clin Nutr, 2005; 81: 583-589.
13. Herrington DM, Reboussin DM, Brosnihan KB et al. Effects of estrogen replacement on the progression of coronary artery atherosclerosis. N Engl J Med, 2000; 343: 522-529.
14. Zhao G, Etherton TD, Martin KR, West SG, Gillies PJ, Kris-Etherton PM. Dietary alpha-linolenic acid. reduces inflammatory and lipid cardiovascular risk factors in hypercholesterolemic men and women. J Nutr, 2004; 134: 2991-2997.
15. Mori TA, Woodman RJ, Burke V, Puddey IB, Croft KD, Beilin LJ. Effect of eicosapentaenoic acid and docosahexaenoic acid on oxidative stress and inflammatory markers in treated-hypertensive type 2 diabetic subjects. Free Radic Biol Med, 2003; 35: 772-781.
16. Murphy MG, Wright V, Scott J, Timmons A, Ackman RG. Dietary menhaden, seal, and corn oils differentially affect lipid and ex vivo eisosanoid and thiobarbituric acid-reactive substances generation in the guinea pig. Lipids, 1999; 34: 115-124.
17. Moss AJ, Goldstein RE, Marder VJ et al. Thrombogenic risk factors and recurrent coronary events. Circulation, 1999; 99: 2517-2522.
18. Tomer A, Kasey S, Connor WE, Clark S, Harker LA, Eckman JR. Reduction of pain episodes and prothrombotic activity in sickle cell disease by n-3 fatty acids. Thromb Haemost, 2001; 85: 966-974.
19. Kenny D, Warltier DC, Pleuss JA, Hoffman RG, Goodfriend TL, Egan BM. Effect of omega-3 fatty acids on the vascular response to angiotensin in normotensive men. Am J Cardiol, 1992; 70: 1347-1352.
20. McCarthy MF. Fish oil and other nutritional adjuvants for treatment of congestive heart failure. Medical Hypotheses, 1996; 46: 400-406.
21. Webe KT, Brilla CG. Pathological hypertrophy and cardiac interstitium. Fibrosis and renin-angiotensin-aldosterone system. Circulation, 1991; 83: 1849-1865.
22. The Consensus Trial Study Group. Effects of enalapril on mortality in severe congestive health failure. N Engl J Med, 1987; 316: 1429-1435.
23. The SOLVD Investigators. Effects of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med, 1991; 325: 293-302.
24. Konstam MA, Rousseau MF, Kronenberg MW et al. Effects of the angiotensin converting enzyme inhibitor enalapril on the long-term progression of left ventricular dysfunction in patients with heart failure. Circulation, 1992; 86: 431-438.
25. Sesselberg HW, Moss AJ, Steinberg J et al. Factors associated with ventricular inducibility in the MADIT II population. Am J Cardiol, 2000; 91: 1002-1004.
26. Murnaghan MF. Effects of fatty acids on the ventricular arrhythmia threshold in the isolated heart of the rabbit. Br J Pharmacol, 1981; 73: 909-915.
27. Leaf A, Kang JX, Xiao Y, Billman GE. Clinical prevention of sudden death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation, 2003; 107: 2646-2652.
28. Billman GE, Schwartz PJ, Stone HL. Baroreceptor reflex control of heart rate: predictor of sudden cardiac death. Circulation, 1989; 66: 874-880.
29. Kang JX, Leaf A. Antiarrythmic effects of polyunsaturated fatty acids. Recent studies. Circulation, 1996; 94: 1774-1780.
30. Nair SS, Leitch JW, Falconer J, Garg ML. Prevention of cardiac arrythmia by dietary (n-3) polyunsaturated fatty acids and their mechanism of action. J Nutr, 1997; 127: 383-393.
31. Vajreswari A, Narayanareddy K. Effect of dietary fats on some membrane-bound enzyme activities, membrane lipid composition and fatty acid profiles of rat heart sarcolemma. Lipids, 1992; 27: 339-343.
32. Grynberg A, Fournier A, Sergiel JP, Athias P. Membrane docosahexaenoic acid and the beating function of the cardiomyocytes and its regulation through the adrenergic recptors. Lipids, 1996; 31: S205-S210.
33. Goode GK, Garcia S, Heagerty AM. Dietary supplementation with marine fish oil improves in vitro small artery endothelial function in hypercholesterolemic patients. Circulation, 1997; 96: 2802-2807.
34. Nestel P, Shige H, Pomeroy S, Cehun M, Abbey M, Raederstorff D. The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. Am J Clin Nutr, 2002; 76: 326-330.
35. van Ravenswaaij-Arts CMA, Kollee LAA, Hopman JCW et al. Heart rate variability. Ann Intern Med, 1993; 118: 436-437.
36. Stein PK, Bosner MS, Kleiger RE, Conger BM. Heart rate variability: a measure of cardiac autonomic tone. Am Heart J, 1994; 127: 1376-1381.
37. Grimsgaard S, Bonase KH, Hansen JB et al. Effects of highly purified eicosapentaenoic acid and docosahexaenoic acid on hemodynamics in humans. Am J Clin Nutr, 1998; 68: 52-59.
38. Christensen JH, Gustenhoff P, Korup E et al. Effect of fish oil on heart rate variability in survivors of myocardial infarction: a double blind randomised controlled trial. BMJ, 1996; 312: 677-678.
39. Mozaffarian D, Gottdiener J, Siscovick D. Intake of tuna or other broiled or baked fish versus fried fish and cardiac structure, function, and hemodynamics. Am J Cardiol, 2006; 97: 216-222.
40. Stone NJ. Fish consumption, fish oil, lipids, and coronary heart disease. Circulation, 1996; 94: 2337-2340.
41. Daviglus ML, Stamler J, Orencia AJ et al. Fish consumption and the 30-year risk of fatal myocardial infarction. N Eng J Med, 1997; 336: 1046-1053.
42. Zhang J, Sasaki S, Amano K, Kesteloot H. Fish consumption and mortality from all causes, ischemic heart disease, and stroke: an ecological study. Prev Med, 1999; 28: 520-529.
43. Hu FB, Bronner L, Willett WC et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA, 2002; 287: 1815-1821.
44. Albert CM, Hennekens CH, O'Donnell CJ et al. Fish consumption and risk of sudden cardiac death. JAMA, 1998; 279: 23-28.
45. Ascherio A, Rimm EB, Stampfer MJ, Giovannucci EL, Willett WC. Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. N Eng J Med, 1995; 332: 977-982.
46. Kromhout D, Bloemberg BP, Feskens EJ, Hertog MG, Menotti A, Blackburn H. Alcohol, fish, fibre and antioxidant vitamins intake do not explain population differences in coronary heart disease mortality. Int J Epidemiol, 1996; 25: 753-759.
47. Pedersen JI, Ringstad J, Almendingen K, Haugen TS, Stensvold I, Thelle DS. Adipose tissue fatty acids and risk for myocardial infarction - a case-control study. Eur J Clin Nutr, 2000; 54: 618-625.
48. Miettinen TA, Naukkarinen V, Huttenen JK, Mattila S, Kumlin T. Fatty-acid composition of serum lipids predicts myocardial infarction. Br Med J, 1982; 285: 993-996.
49. Rissanen T, Voutilainen S, Nyyssonen K, Lakka TA, Salonen JT. Fish-oil derived fatty acids, docosahexaenoic acid and docosapentaenoic acid, and the risk of acute coronary events: The Kuopio ischaemic heart disease risk factor study. Circulation, 2000; 102: 2677-2679.
50. Simon JS, Hodgkins ML, Browner WS, Neuhaus JM, Bernert JT Jr., Hulley SB. Serum fatty acids and the risk of coronary heart disease. Am J Epidemiol, 1995; 142: 469-476.
51. Siscovick DS, Raghunathan TE, King I et al. Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. JAMA, 1995; 275: 1363-1367.
52. Albert CM, Campos H, Stampfer MJ et al. Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med, 2002; 346: 1113-1118.
53. Guallar E, Aro A, Jiminez FJ et al. Omega-3 fatty acids in adipose tissue and risk of myocardial infarction: the EURAMIC study. Arteriosclerosis Thromb Vasc Biol, 1999; 19: 1111-1118.
54. Guallar E, Hennelens CH, Sacks FM, Willett WC, Stampfer MJ. A prospective study of plasma fish oil levels and incidence of myocardial infarction in U.S. male physicians. J Am Coll Cardiol, 1995; 25: 387-394.
55. Ohrvall M, Berglund L, Salminen I, Lithel H, Aro A, Vessby B. The serum cholesterol ester fatty acid composition but not the serum concentration of alpha tocopherol predicts the development of myocardial infarction in 50-year old men: 18 years follow-up. Atherosclerosis, 1996; 127: 65-71.
56. Lemaitre RN, King IB, Raghunathan TE et al. Cell membrane trans-fatty acids and the risk of primary cardiac arrest. Circulation, 2002; 105: 697-701.
57. de Lorgeril M, Renaud S, Mamelle N et al. Mediterranean alpha-linolenic acid-rich diet in secondary prevention of coronary artery disease. Lancet, 1994; 343: 1454-1459.
58. GISSI-Prevenzione Investigators. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet, 1999; 354: 447-455.
59. Marchioli R, Barzi Federica, Bomba E; on behalf of the GISSI-Prevenzione Investigators. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation, 2002; 105: 1897-1903.
60. Burr ML, Ashfield-Watt PAL, Dunstan FDJ et al. Lack of benefit of dietary advice to men with angina: results of a controlled trial. Eur J Clin Nutr, 2003; 57: 193-200.
61. Nilsen DWT, Albrektsen G, Landmark K, Moen S, Arsland T, Woie L. Effects of a high-dose concentrate of n-3 fatty acids or corn oil introduced early after an acute myocardial infarction on serum triacylglycerol and HDL cholesterol. Am J Clin Nutr, 2001; 74: 50-56.
62. Erkkilä AT, Lehto S, Pyorala K, Uusitupa Matti IJ. n-3 fatty acids and 5-y risks of death and cardiovascular disease events in patients with coronary heart disease. Am J Clin Nutr, 2003; 78: 65-71.
63. Sacks FM, Stone PH, Gibson CM, Silverman DI, Rosner B, Pasternak RC. Controlled trial of fish oil for regression of human coronary atherosclerosis. HARP Research Group. J Am Coll Cardiol, 1995; 25: 1492-1498.
64. von Schacky C, Angerer P, Kothny W, Theisen K, Mudra H. The effect of dietary omega-3 fatty acids on coronary atherosclerosis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med, 1999; 130: 554-562.
65. Eritsland J, Arnesen H, Gronseth K, Fjeld NB, Abdelnoor M. Effect of dietary supplementation with n-3 fatty acids on coronary artery bypass graft patency. Am J Cardiol, 1996; 77: 31-36.
66. Raitt MH, Connor WE, Morris C et al. Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: A randomized controlled trial. JAMA, 2005; 293: 2884-2891.
67. Moss AJ, Hall WJ, Cannom DS et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Eng J Med, 1996; 335: 1933-1940.
68. Leaf A, Albert CM, Josephson M et al.; for the Fatty Acid Antiarrhythmia Trial Investigators. Prevention of fatal arrhythmias in high-risk subjects by fish oil n-3 fatty acid intake. Circulation, 2005; 112: 2762-2768.
69. Brouwer IA, Zock PL, Camm AJ et al.; for the SOFA Study Group. Effect of fish oil on ventricular tachyarrhythmia and death in patients with implantable cardioverter defibrillators: The Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) Randomized Trial. JAMA, 2006; 295: 2613-2619.
70. Harris WS. Extending the cardiovascular benefits of omega-3 fatty acids. Curr Atheroscler Rep, 2005; 7: 375-380.
71. Hooper L, Thompson RL, Harrison Roger A et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. Br Med J, 2006; 332: 752-760.
72. Cohen JT, Bellinger DC, Connor WE et al. A quantitative risk-benefit analysis of changes in population fish consumption. Am J Prev Med, 2005; 29: 325-334.
73. Konig A, Bouzan C, Cohen JT et al. A quantitative analysis of fish consumption and coronary heart disease mortality. Am J Prev Med, 2005; 29: 335-346.
74. Willett WC. Fish: balancing health risks and benefits. Am J Prev Med, 2005; 29: 320-321.
75. U.S. Food and Drug Administration Center for Drug Evaluation and Research. Omacor Consumer Drug Information Sheet. Available at: http://www.fda.gov/cder/consumerinfo/druginfo/omacor.htm. Accessed June 16, 2006.
76. Reliant Pharmaceuticals. OMACOR Omega-3-acid ethyl esters. Available at: http://www.omacorrx.com/About_OMACORBenefits_of_OMACOR.html?kwcid= 110&s_kwcid=omacor/447306500. Accessed June 16, 2006.
77. Department of Health and Human Services, US Food and Drug Administration. Substances generally regarded as safe: menhaden oil. Available at: http://www.cfsan.fda.gov/~kd/fr040115.html. Accessed June 16, 2006.
78. Office of Nutritional Products, Labeling, and Dietary Supplements Center for Food Safety and Applied Nutrition U.S. Food and Drug Administration. Letter responding to a request to reconsider the qualified claim for a dietary supplement health claim for omega-3 fatty acids and coronary heart disease. Docket No. 91N-0103. Available at: http://www.cfsan.fda.gov//~dms/ds-ltr28.html. Accessed June 16, 2006.
79. Simopoulos AP. Evolutionary aspects of omega-3 fatty acids in the food supply. Prostaglandins Leukotriennes & Essential Fatty Acids, 1999; 60: 421-429.
80. Djousse L, Pankow JS, Eckfelt JH et al. Relation between dietary linolenic acid and coronary artery disease in the National Heart, Lung, and Blood Institute Family Heart Study. Am J Clin Nutr, 2001; 74: 612-619.
81. Mozaffarian D, Ascherio A, Hu FB et al. Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation, 2005; 111: 166-173.
82. Goyens PL, Mensink RP. The dietary alpha-linolenic acid to linoleic acid ratio does not affect the serum lipoprotein profile in humans. J Nutr, 2005; 135: 2799-2804.
83. Pischon T, Hankinson SE, Hotamisligil GS, Rifai N, Willett WC, Rimm EB. Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women. Circulation, 2003; 108: 155-160.
84. Josephson M, Wellens HJ. Implantable defibrillators and sudden cardiac death. Circulation, 2004; 109: 2685-2691.
85. Harris WS, von Schacky C. The Omega-3 Index: a new risk factor for death from coronary heart disease? Prev Med, 2004; 39: 212-220.
86. Weylandt KH, Kang JX. Rethinking lipid mediators. Lancet 2005; 355: 618-620.
87. Serhan CN. Novel eicosanoid and docosanoid mediators: resolvins, docosatrienes, and neuroprotectins. Curr Opin Clin Nutr Metab Care, 2005; 8: 115-121.