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

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• 作者：Yoshihiro Fukuoka ; MD^a ; ^{dukuy2413@gmail.com" class="auth_mail} ; ^{fukuyoshi2413@yahoo.co.jp" class="auth_mail} ; Norihito Nuruki ; MD^a ; Shun Amiya ; MD ; PhD^a ; Katsunori Tofuku ; MD^a ; Shinichiro Aosaki ; MD ; PhD^b ; Hirohito Tsubouchi ; MD ; PhD^a
• 关键词：Brachial-ankle pulse wave velocity ; Fish-based diet ; Eicosapentaenoic acid ; Ratio of plasma eicosapentaenoic acid to arachidonic acid (EPA/AA ratio) ; Coronary artery disease
• 刊名：Journal of Cardiology
• 出版年：March, 2014
• 年：2014
• 卷：63
• 期：3
• 页码：211-217
• 全文大小：986 K

文摘

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 卤 0.18 vs. 0.49 卤 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: 鈭?5 卤 164 cm/s, high-risk: 鈭?4 卤 190 cm/s, CAD: 39 卤 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 卤 0.57 vs. 1.19 卤 0.46, p < 0.001), accompanied by significant reduction in baPWV (1968 卤 344 cm/s vs. 1829 卤 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 = 鈭?.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.