Effects of a fish-based diet and administration of pure eicosapentaenoic acid on brachial-ankle pulse wave velocity in patients with cardiovascular risk factors

• Published in: Journal of cardiology Vol. 63; no. 3; pp. 211 - 217
• Main Authors: Fukuoka, Yoshihiro, MD, Nuruki, Norihito, MD, Amiya, Shun, MD, PhD, Tofuku, Katsunori, MD, Aosaki, Shinichiro, MD, PhD, Tsubouchi, Hirohito, MD, PhD
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.03.2014
• Subjects: Aged; Animals; Ankle - blood supply; Arachidonic Acid - blood; Biomarkers - blood; Brachial Artery - physiopathology; Brachial-ankle pulse wave velocity; Cardiovascular; Coronary artery disease; Coronary Artery Disease - blood; Coronary Artery Disease - diagnosis; Coronary Artery Disease - physiopathology; Coronary Artery Disease - prevention & control; Diet; Dietary Supplements; Eicosapentaenoic acid; Eicosapentaenoic Acid - administration & dosage; Eicosapentaenoic Acid - blood; Female; Fish Products; Fish-based diet; Fishes; Humans; Male; Middle Aged; Multivariate Analysis; Pulse Wave Analysis; Ratio of plasma eicosapentaenoic acid to arachidonic acid (EPA/AA ratio); Risk Factors; Fish-based diet; Brachial-ankle pulse wave velocity; Eicosapentaenoic acid; Coronary artery disease; Ratio of plasma eicosapentaenoic acid to arachidonic acid (EPA/AA ratio)
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2013.08.005

Abstract Background and purpose Brachial-ankle pulse wave velocity (baPWV) and ratio of plasma eicosapentaenoic acid to arachidonic acid (EPA/AA ratio) are surrogate markers for coronary artery disease (CAD). We aimed to evaluate the effects of a fish-based diet and administration of EPA on baPWV and plasma EPA/AA ratio. Methods and results The changes in baPWV and plasma EPA/AA ratio were compared before and after a 6-month fish-based diet in 191 patients with cardiovascular risk factors. A fish-based diet resulted in significant increment of plasma EPA/AA ratio (0.40 ± 0.18 vs. 0.49 ± 0.27, p < 0.001), with baPWV remaining unchanged. Multivariate analysis revealed that systolic blood pressure (SBP) (6-month SBP-baseline SBP) and CAD were positively associated with increased baPWV (CAD: odds ratio = 2.040, p = 0.0436, SPB: odds ratio = 1.056, p = 0.0003). When the patients were divided into three groups: CAD, low-risk, and high-risk with no prior history of CAD according to the number of risk factors at baseline, comparison among the three groups disclosed an inter-group difference in the magnitude of change in baPWV (low-risk: −35 ± 164 cm/s, high-risk: −14 ± 190 cm/s, CAD: 39 ± 164 cm/s, p = 0.0071 for trend). In 191 patients who had received a 6-month fish-based diet, 21 patients (primarily CAD patients) sequentially received high purity EPA (1800 mg/day) for 6 months. It resulted in marked increment of plasma EPA/AA ratio (0.65 ± 0.57 vs. 1.19 ± 0.46, p < 0.001), accompanied by significant reduction in baPWV (1968 ± 344 cm/s vs. 1829 ± 344 cm/s, p = 0.0061). There was a significant negative correlation between changes in baPWV and changes in plasma EPA/AA ratio in patients with a fish-based diet and sequential administration of EPA ( r = −0.446, p = 0.017). Conclusion A fish-based diet was effective against increased baPWV only in low-risk patients, with slight increment of plasma EPA/AA. In high-risk patients and CAD patients, administration of EPA for preventing progression of baPWV endorsed the validity of high purity EPA administration recommended in the current guidelines.