Effect of B-vitamins and n-3 PUFA supplementation for 5 years on blood pressure in patients with CVD. Effect of fatty and lean fish intake on lipoprotein subclasses in subjects with coronary heart disease: a controlled trial. Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients. Docosahexaenoic Acid Supplementation, Vascular Function and Risk Factors for Cardiovascular Disease: A Randomized Controlled Trial in Young Adults Randomized placebo-controlled intervention with n-3 LC-PUFA-supplemented yoghurt: effects on circulating eicosanoids and cardiovascular risk factors. Marine n-3 fatty acids, atrial fibrillation and QT interval in haemodialysis patients. Acute supplementation with eicosapentaenoic acid reduces platelet microparticle activity in healthy subjects. Omega-3 in SLE: a double-blind, placebo-controlled randomized clinical trial of endothelial dysfunction and disease activity in systemic lupus erythematosus Effects of omega-3 fatty acids on arterial stiffness in patients with hypertension: a randomized pilot study Effects of similar intakes of marine n-3 fatty acids from enriched food products and fish oil on cardiovascular risk markers in healthy human subjects. Dose-dependent consumption of farmed Atlantic salmon (Salmo salar) increases plasma phospholipid n-3 fatty acids differentially. n-3 fatty acids in patients with multiple cardiovascular risk factors. Effects on Serum Fractalkine by Diet and Omega-3 Fatty Acid Intervention: Relation to Clinical Outcome Platelet Redox Balance in Diabetic Patients With Hypertension Improved by n-3 Fatty Acids Effects of omega-3 polyunsaturated fatty acids on platelet function in healthy subjects and subjects with cardiovascular disease. Interaction between a CSK gene variant and fish oil intake influences blood pressure in healthy adults. &ohgr;-3 fatty acid treatment in cardiac syndrome X: a double-blind, randomized, placebo-controlled clinical study Comparison of the effects of n-3 long chain polyunsaturated fatty acids and fenofibrate on markers of inflammation and vascular function, and on the serum lipoprotein profile in overweight and obese subjects. Impaired Fetal Growth and Arterial Wall Thickening: A Randomized Trial of Omega-3 Supplementation Omega-3 fatty acid therapy reduces triglycerides and interleukin-6 in hypertriglyeridemic HIV patients. Effects of omega-3 fatty acids on postprandial triglycerides and monocyte activation. Short communication: effects of omega-3 fatty acids on triglycerides and high-density lipoprotein subprofiles in HIV-infected persons with hypertriglyceridemia. A fish-based diet intervention improves endothelial function in postmenopausal women with type 2 diabetes mellitus: a randomized crossover trial.
Certain epidemiological and experimental studies suggest that n-3 fatty acids and folate can reduce blood pressure ( BP ) . We investigated the effect of a daily supplementation with dietary doses of B-vitamins or n-3 fatty acids for 5 years on BP in patients with a history of CVD who participated in the Supplémentation en Folates et Omega-3 trial . The patients ( n 2501 ; 1987 men and 514 women ) were r and omly assigned in a 2 × 2 factorial design to one of four groups : B-vitamins ( 5-methyl-THF ( 560 μg ) ; vitamin B₆ ( 3 mg ) and vitamin B₁₂ ( 20 μg ) ) and a placebo capsule for n-3 fatty acids ; n-3 fatty acids ( 600 mg of EPA and DHA at a ratio of 2:1 ) and a placebo capsule for B-vitamins ; both B-vitamins and n-3 fatty acids ; or placebo capsules for both treatments . The patients took two capsules daily in a double-blind manner for a median duration of 4·7 years . At baseline and annual examination for 5 years , the patients underwent a clinical examination where BP and clinical and biological parameters were assessed . No effect of supplementation with either n-3 PUFA or B-vitamins  on BP was observed in crude and adjusted multivariate models . Change in BP was not associated with change in homocysteine . In conclusion , the present results do not support the routine use of dietary supplements containing B-vitamins , or of n-3 fatty acids , to reduce BP in people with prior CVD BACKGROUND Fish oil intake reduces serum triglycerides ; however , little is known about the effects of dietary fish intake on lipoprotein subclasses . OBJECTIVE We aim ed at assessing the effect of fatty and lean fish intake on the lipoprotein subclasses in an intervention study . METHODS The intervention study included 33 patients with coronary heart disease , who were aged 61.0 ± 5.8 ( mean ± SD ) years . The subjects were r and omly assigned to a fatty fish ( n = 11 ) , lean fish ( n = 12 ) , or control ( n = 10 ) diet for 8 weeks . Fish diets included at least 4 fish meals per week . Subjects in the control group consumed lean beef , pork , and chicken . Lipoprotein subclasses and their lipid components were determined by nuclear magnetic resonance spectroscopy . RESULTS Concentrations of n-3 fatty acids and docosahexaenoic acid increased in the fatty fish group . The concentrations of cholesterol , cholesterol esters , and total lipids in very large high-density lipoproteins ( HDLs ) increased in the fatty fish group ( overall difference P = .005 , P = .002 , and P = .007 , respectively ; false discovery rate P = .04 , P = .04 , and P = .05 , respectively ) . The mean size of HDL particles increased in the fatty fish group ( 9.8 ± 0.3 nm at baseline and 9.9 ± 0.4 nm at end of study ; overall difference P = .004 , false discovery rate P = .04 ) . The fish diets did not affect very-low-density lipoprotein or low-density lipoprotein size . CONCLUSION Fatty fish intake at least 4 times per week increases HDL particle size which might have beneficial effect in patients with coronary heart disease Vitamin D deficiency , low levels of fetuin-A , and fibroblast growth factor 23 ( FGF-23 ) are related to vascular calcification , which is associated with cardiovascular disease . We hypothesized that omega-3 fatty acid ( FA ) , which has cardioprotective properties , modifies vitamin D status , fetuin-A , and FGF-23 levels in dialysis patients . In a r and omized , open-label , controlled study , a total of 47 patients treated with dialysis for at least 1 year were r and omized to treatment for 6 months with omega-3 FAs ( Omacor , 3 g/d ; Pronova , S and efjord , Norway ) or a control group . Levels of fetuin-A and FGF-23 were measured by enzyme-linked immunoassay , 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D were measured by radioimmunoassay . The mean age of the enrolled patients was 57.4 ± 10.4 years , and mean dialysis duration was 46.5 ± 28.1 months . Twenty-seven hemodialysis patients and 16 peritoneal dialysis patients finished this trial . After 6 months , the levels of 1,25-dihydroxyvitamin D and fetuin-A were significantly increased in the group taking the omega-3 FA supplement compared with baseline . Levels of calcium , phosphorous , parathyroid hormone , 25-hydroxyvitamin D , FGF-23 , and lipid profiles were not significantly changed in the omega-3 FA-supplemented group after 6 months compared with baseline . The erythrocyte membrane contents of eicosapentaenoic acid and docosahexaenoic acid were significantly increased , and oleic acid content was significantly decreased in the omega-3 FA-supplemented group after 6 months compared with baseline . Regarding vascular calcification and cardiovascular disease , omega-3 FA supplementation may have a clinical benefit caused by activating vitamin D , increasing fetuin-A levels , and modifying erythrocyte membrane FA contents in dialysis patients Background A high consumption of omega‐3 long‐chain polyunsaturated fatty acids , and particularly docosahexaenoic acid ( DHA ) , has been suggested to reduce the risk of cardiovascular disease ( CVD ) . However , while DHA supplementation may have benefits for secondary prevention , few studies have investigated the role of DHA in the primary prevention of CVD . Here , we tested the hypothesis that DHA supplementation  improves endothelial function and risk factors for CVD . Methods and Results Healthy volunteers ( n=328 ) , aged 18 to 37 years , were r and omly assigned to 1.6 g DHA/day ( from a microalgae source ) together with 2.4 g/day carrier oil ( index group ) or to 4.0 g/day olive oil ( control ) ( both given in eight 500‐mg capsules/day for 16 weeks ) . Flow‐mediated endothelium‐dependent vasodilation ( FMD ) of the brachial artery ( primary outcome ) was measured before and after the intervention ( n=268 ) using high‐resolution vascular ultrasound . FMD was the same in both groups at r and omization ( mean , SD ; 0.27 , 0.1 mm ) , but postintervention was higher in the control group ( 0.29 , 0.1 mm ) compared with the DHA‐supplemented group ( 0.26 , 0.1 mm ; mean difference −0.03 mm ; 95 % CI −0.005 to −0.06 mm ; P=0.02 ) . Of other outcomes , only triglyceride ( mean difference −28 % , 95 % CI −40 % to −15 % ; P<0.0001 ) and very low‐density lipoprotein concentrations were significant lower in DHA‐supplemented individuals compared with controls . Conclusions DHA supplementation did not improve endothelial function in healthy , young adults .  Nevertheless , lower triglyceride concentrations with DHA supplementation was consistent with previous reports and could have benefits for the prevention of CVD . Clinical Trial Registration Information URL : http://www.controlled-trials.com/ Unique identifier : IS RCT N no : 19987575 BACKGROUND & AIMS The study examined the value of n-3 LC-PUFA-enriched yogurt as means of improving cardiovascular health  . DESIGN Fifty three mildly hypertriacylglycerolemic subjects ( TAG ≥ 1.7 mmol/L ) participated in a r and omized , placebo-controlled , double-blind , parallel design ed study . The subjects consumed 1 ) control yoghurt ; 2 ) yoghurt enriched with 0.8 g n-3 LC-PUFA/d ; or 3 ) yoghurt enriched with 3 g n-3 LC-PUFA/d for a period of 10 wks . Blood sample s were taken at the beginning and the end of the study period . RESULTS Following daily intake of 3 g n-3 LC-PUFA for 10 weeks , n-3 LC-PUFA levels increased significantly in plasma and red blood cells ( RBC ) with concomitant increase in the EPA-derived mediators ( PGE₃ , 12- , 15- , 18-HEPE ) in plasma whilst cardiovascular risk factors such as HDL , TAG , AA/EPA ratio , and n-3 index were improved ( P < 0.05 ) ; the decrease of TAG and increase in HDL were associated with the CD36 genotype . CONCLUSION The observed increase of n-3 LC-PUFA in RBC and plasma lipids due to intake of n-3 LC-PUFA enriched yoghurt result ed in a reduction of cardiovascular risk factors and inflammatory mediators showing that daily consumption of n-3 PUFA enriched yoghurt can be an effective way of supplementing the daily diet and improving cardiovascular health Patients treated with haemodialysis are at high risk of sudden cardiac death ( SCD ) often caused by arrhythmias . Atrial fibrillation ( AF ) is frequent among haemodialysis patients and is associated with increased mortality . Prolonged QTc is a risk marker of ventricular arrhythmia and is thereby associated with SCD . Studies have suggested that n-3 PUFA may have an antiarrhythmic effect , but the exact mechanism is not clear . The aim of this study was to examine whether AF was associated with n-3 PUFA in plasma phospholipids and whether supplementation with n-3 PUFA would shorten the QTc interval in haemodialysis patients compared to placebo . In a double-blinded r and omised , placebo-controlled intervention trial 206 haemodialysis patients with CVD were treated with 1·7 g n-3 PUFA or placebo ( olive oil ) daily for 3 months . Blood sample s and electrocardiogram evaluations were carried out at baseline and after 3 months . The QT interval , PQ interval and heart rate were measured in all patients with sinus rhythm ( SR ) . At baseline 13 % of patients had AF . The content of the n-3 PUFA , DHA , was significantly lower ( P < 0·05 ) in serum of patients with AF compared with patients with SR . Thus , the DHA content was independently negatively associated with AF . Supplementation with n-3 PUFA did not shorten the QT interval significantly compared to the placebo group ( P = 0·42 ) , although subgroup analysis within the n-3 PUFA group revealed a shortening effects on QTc ( P = 0·01 ) . In conclusion , an inverse association was found between the presence of AF and the plasma DHA in haemodialysis patients . Intervention with n-3 PUFA did not shorten the QTc interval  compared to placebo BACKGROUND Dietary supplementation with omega-3 fatty acids has been associated with reduced incidence in thrombotic events . In addition , administration of n-3 polyunsaturated fatty acids ( PUFAs ) has been shown to rectify elevated platelet microparticle ( MP ) number and procoagulant activity in post myocardial infa rct ion patients . However , it is unknown whether supplementation can alter these parameters in healthy individuals and if such effects are immediate or require long-term supplementation . We have previously demonstrated a gender-specific effect of LCn-3PUFA supplementation on platelet aggregation in healthy human subjects . Here we extend these findings to include the acute effects of supplementation with EPA- or DHA-rich oils on circulating MP levels and activity in healthy subjects . DESIGN A placebo-controlled trial was conducted in healthy males and females ( n=30 ) .  MP activity , MP levels and platelet aggregation were measured at 0 and 24 h postsupplementation with either a placebo or EPA- or DHA-rich oil . RESULTS Both EPA and DHA effectively reduced platelet aggregation at 24 h postsupplementation relative to placebo ( -13.3 % , P=.006 and -11.9 % , P=.016 , respectively ) , but only EPA reduced MP activity ( -19.4 % , P=.003 ) . When grouped by gender , males showed a similar reduction in both platelet aggregation and MP activity ( -20.5 % , P=.008 ; -22 % , P=.008 ) following EPA , while females showed significantly reduced platelet aggregation ( -13.7 % , P=.04 ) but not MP activity after DHA only . CONCLUSION EPA and DHA exert gender-dependent effects on platelet aggregation and platelet MP activity , but not on MP levels . With respect to thrombotic disease risk , males may benefit more from EPA supplementation Accelerated atherosclerosis remains a major cause of death in late systemic lupus erythematosus ( SLE ) .  Omega-3 has been reported to have benefit for endothelial dysfunction , one of the earliest stages of atherosclerosis , and to reduce disease activity in SLE . We performed a r and omized , double-blind placebo-controlled trial to examine the effect of Omega-3 on endothelial function , disease activity , inflammatory markers and lipids in SLE . SLE patients ( n = 85 , mean age 47 , 55 % Caucasian , 38 % African-American , 94 % female ) were r and omly assigned to 3 g of Omega-3 ( Lovaza , GSK ) versus placebo for 12 weeks . Endothelial function was measured at baseline and at 12 weeks using flow-mediated dilation , calculated using high-resolution B-mode ultrasound of the brachial artery diameter in response to vasoactive stimuli ( hyperemia ) . Disease activity was measured using the physician global assessment and SELENA-SLEDAI score . Inflammatory markers ( sICAM-1 , sVCAM-1 , IL-6 ) and fasting lipid profile were done at baseline and 12-week follow-up . There was no difference between the treatment groups with respect to changes in flow-mediated dilation parameters or disease activity . An average increase in LDL cholesterol of 3.11 mg/dL ( ±21.99 ) was found with Omega-3 versus a decrease of 1.87 mg/dL ( ±18.29 ) with placebo ( p = 0.0266 ) . In this trial , Omega-3 did not improve endothelial function , disease activity , nor reduce inflammatory markers in SLE . Longer trials might be required if there are delayed clinical effects . There was evidence that Omega-3 may increase LDL cholesterol , but not the LDL/HDL ratio Background Omega–3 fatty acids prevent cardiovascular disease ( CVD ) events in patients with myocardial infa rct ion or heart failure . Benefits in patients without overt CVD have not been demonstrated , though most studies did not use treatment doses ( 3.36 g ) of omega-3 fatty acids .  Arterial stiffness measured by pulse wave velocity ( PWV ) predicts CVD events independent of st and ard risk factors . However , no therapy has been shown to reduce PWV in a blood pressure-independent manner . We assessed the effects of esterified omega–3 fatty acids on PWV and serum markers of inflammation among patients with hypertension . Design and methods We performed a prospect i ve , r and omized ; double-blinded pilot study of omega-3 fatty acids among 62 patients in an urban , safety net hospital . Patients received 3.36 g of omega–3 fatty acids vs. matched placebo daily for 3-months . The principal outcome measure was change in brachial-ankle PWV . Serum inflammatory markers associated with CVD risk were also assessed . Results The majority ( 71 % ) were of Latino ethnicity . After 3-months , mean change in arterial PWV among omega-3 and placebo groups was −97 cm/s vs. −33 cm/s respectively ( p = 0.36 for difference , after multivariate adjustment for baseline age , systolic blood pressure , and serum adiponectin ) . Non-significant reductions in lipoprotein-associated phospholipase A2 ( LpPLA2 ) mass and high sensitivity C-reactive protein ( hsCRP ) relative to placebo were also observed ( p = 0.08 , and 0.21 , respectively ) . Conclusion High-dose omega-3 fatty acids did not reduce arterial PWV or markers of inflammation among patients within a Latino-predominant population with hypertension . Clinical trial registration NCT00935766 , registered July 8 2009 There is convincing evidence that consumption of fish and fish oil rich in long-chain ( LC ) n-3 PUFA ( n-3 LCPUFA ) , EPA ( 20 : 5n-3 ) and DHA ( 22 : 6n-3 ) reduce the risk of CHD . The aim of the present study was to investigate whether n-3 LCPUFA-enriched food products provide similar beneficial effects as fish oil with regard to incorporation into plasma lipids and effects on cardiovascular risk markers . A parallel 7-week intervention trial was performed where 159 healthy men and women were r and omised to consume either 34 g fish pâté ( n 44 ) , 500 ml fruit juice ( n 38 ) or three capsules of concentrated fish oil ( n 40 ) , all contributing to a daily intake of approximately 1 g EPA and DHA . A fourth group did not receive any supplementation or food product and served as controls ( n 37 ) . Plasma fatty acid composition , serum lipids , and markers of inflammation and oxidative stress were measured . Compared with the control group , plasma n-3 LCPUFA and EPA : arachidonic acid ratio increased equally in all intervention groups . However , no significant changes in blood lipids and markers of inflammation and oxidative stress were observed . In conclusion , enriched fish pâté and fruit juice represent suitable delivery systems for n-3 LCPUFA . However , although the dose given is known to reduce the risk of CVD , no significant changes were observed on cardiovascular risk markers in this healthy population Enhanced n-3 fatty acid intake benefits cardiovascular disease ( CVD ) risk reduction . Increasing consumption at a population level may be better addressed by diet than through supplementation . However , limited data are available on the effect of the dose response to fish intake on plasma levels of n-3 fatty acids . To compare the effects of different doses of farmed Atlantic salmon on plasma phospholipid fatty acid proportions and CVD risk biomarkers ( eg , glucose , insulin , homeostasis model of assessment -insulin resistance , high-sensitivity C-reactive protein , and interleukin-6 ) in healthy subjects we performed a r and omized three-period crossover- design ed trial ( 4-week treatment , 4- to 8-week washout ) to compare the effects of twice per week consumption of farmed Atlantic salmon at doses of 90 , 180 , and 270 g in 19 apparently healthy men and women ( mean age 40 to 65 years ) and a body mass index between 25 and 34.9 . All study visits were conducted at the US Department of Agriculture Agricultural Research Service Gr and Forks Human Nutrition Research Center . Eicosapentaenoic acid and total n-3 concentrations were increased ( P<0.05 ) by all treatments in a dose-response manner , with total n-3 of 8.03 % ± 0.26 % and 9.21 % ± 0.26 % for 180- and 270-g doses , respectively . Linoleic acid did not change in response to treatment , whereas arachidonic acid ( P<0.05 ) and total n-6 fatty acids decreased dose dependently ( < 0.0001 ) . The addition of farmed Atlantic salmon to the diet twice per week for 4 weeks at portions of 180 g and 270 g modifies phospholipid fatty acid proportions of n-3 and n-6 in a level associated with decreased risk for CVD BACKGROUND Trials have shown a beneficial effect of n-3 polyunsaturated fatty acids in patients with a previous myocardial infa rct ion or heart failure . We evaluated the potential benefit of such therapy in patients with multiple cardiovascular risk factors or atherosclerotic vascular disease who had not had a myocardial infa rct ion . METHODS In this double-blind , placebo-controlled clinical trial , we enrolled a cohort of patients who were followed by a network of 860 general practitioners in Italy . Eligible patients were men and women with multiple cardiovascular risk factors or atherosclerotic vascular disease but not myocardial infa rct ion . Patients were r and omly assigned to n-3 fatty acids ( 1 g daily ) or placebo ( olive oil ) . The initially specified primary end point was the cumulative rate of death , nonfatal myocardial infa rct ion , and nonfatal stroke . At 1 year , after the event rate was found to be lower than anticipated , the primary end point was revised as time to death from cardiovascular causes or admission to the hospital for cardiovascular causes . RESULTS Of the 12,513 patients enrolled , 6244 were r and omly assigned to n-3 fatty acids and 6269 to placebo . With a median of 5 years of follow-up , the primary end point occurred in 1478 of 12,505 patients included in the analysis ( 11.8 % ) , of whom 733 of 6239 ( 11.7 % ) had received n-3 fatty acids and 745 of 6266 ( 11.9 % ) had received placebo ( adjusted hazard ratio with n-3 fatty acids , 0.97 ; 95 % confidence interval , 0.88 to 1.08 ; P=0.58 ) . The same null results were observed for all the secondary end points . CONCLUSIONS In a large general- practice cohort of patients with multiple cardiovascular risk factors , daily treatment with n-3 fatty acids did not reduce cardiovascular mortality and morbidity . ( Funded by Società Prodotti Antibiotici and others ; Clinical Trials.gov number , NCT00317707 . ) Introduction . Fractalkine is a chemokine associated with atherosclerosis . Increased serum levels have been reported in unstable coronary artery disease ( CAD ) and to predict mortality in heart failure . Mediterranean-like diet and omega-3 fatty acids ( n3-PUFA ) have documented cardioprotective and anti-inflammatory effects . We have investigated the effect of Mediterranean-like dietary counseling and n-3 PUFA on serum fractalkine in an elderly population and its ability to predict cardiovascular disease ( CVD ) . Material s and Methods . 563 men ( age 64–75 yrs ) at high risk of CAD were r and omized into a 2 × 2 factorial design ed trial for 3-year dietary counseling and /or n-3 PUFA supplementation ( 2.4 g/d ) . Circulating levels of fractalkine were measured at baseline and at end of study . Clinical events were recorded after 3 years . Results . Fractalkine levels were significantly reduced in all groups from baseline to 3 years ( P < 0.001 , all ) , but without between-group differences in changes . Fractalkine levels at baseline were not predictive for CVD events ( n = 68 ) or total mortality . Lower fractalkine levels were observed in smokers ( P = 0.019 ) . Conclusions . Reduced levels of fractalkine from baseline to 3 years were observed , however , without any influence of Mediterranean-like diet or n-3 PUFA supplementation . Fractalkine levels at baseline were not predictive for later CVD events OBJECTIVE Patients with type 2 diabetes mellitus ( T2DM ) are at increased risk of developing cardiovascular disease , largely as a result of defective production of cardioprotective nitric oxide and a concomitant rise in oxidative stress . Dietary interventions that could reverse this trend would be extremely beneficial . Here we investigated whether dietary n-3 polyunsaturated fatty acid ( n-3 PUFA ) supplementation positively affected platelet nitroso-redox imbalance . RESEARCH DESIGN AND METHODS We r and omized hypertensive T2DM patients ( T2DM HT ; n = 22 ) and age- and -sex matched hypertensive study participants without diabetes ( HT alone ; n = 23 ) in a double-blind , crossover fashion to receive 8 weeks of n-3 PUFAs ( 1.8 g eicosapentaenoic acid and 1.5 g docosahexaenoic acid ) or identical olive oil capsules ( placebo ) , with an intervening 8-week washout period . Platelet nitrite and superoxide were measured and compared before and after treatment ; 8-isoprostane was determined by ELISA and subcellular compartmentalization of the NAD(P)H oxidase subunit p47-phox examined by Western blotting . RESULTS The n-3 PUFA supplementation reduced 8-isoprostane and superoxide levels in platelets from T2DM HT , but not HT alone , participants , without effect on nitrite production . This coincided with a significant decrease in p47-phox membrane localization and a similar reduction in superoxide to that achieved with apocynin . At baseline , a subcohort of T2DM HT and HT alone participants showed evidence of nitric oxide synthase (NOS)–derived superoxide production , indicating defective enzymatic activity . This was reversed significantly in T2DM HT participants after treatment , demonstrating improved NOS function . CONCLUSIONS Our finding that n-3 PUFAs diminish platelet superoxide production in T2DM HT patients in vivo suggests a therapeutic role for these agents in reducing the vascular-derived oxidative stress associated with diabetes Hyperactivation and aggregation of platelets play a major role in thrombosis and hemostasis . The aims of this study were to investigate the effects of omega-3 polyunsaturated fatty acids ( PUFAs ) on platelet function . Light transmission aggregometry and flow cytometric analyses of platelet activation and platelet-leukocyte aggregates were determined at baseline and after 4 weeks of omega-3 ( docosahexaenoic acid 520 mg and eicosapentaenoic acid 120 mg ) supplementation . In total , 40 healthy subjects and 16 patients with a history of cardiovascular disease ( CVD ) completed the study . In healthy subjects , omega-3 PUFA significantly reduced adenosine diphosphate (ADP)-induced ( maximum amplitude , 77.0 % ± 3.2 % vs. 71.6 % ± 3.4 % , p = 0.036 ; maximum slope , 86.3 ± 1.8 vs. 80.7 ± 2.1 , p = 0.014 ) and adrenaline-induced platelet aggregation ( maximum slope , 42.8 ± 2.7 vs. 37.4 ± 3.0 , p = 0.013 ; lag time , 00:21 ± 00:02 vs. 00:31 ± 00:03 s , p = 0.002 ) . Omega-3 PUFA also reduced P-selectin expression ( 40.5 % ± 2.9 % vs. 34.4 % ± 2.4 % , p = 0.049 ) on platelets and platelet-monocyte aggregates ( 38.5 % ± 2.6 % vs. 31.4 % ± 2.5 % , p = 0.022 ) after activation with ADP 0.5 µM. There were fewer changes in platelet aggregation and activation found in subjects with CVD . Nevertheless , there was a reduction in the slope of arachidonic acid-induced platelet aggregation ( 13.21 ± 6.41 vs. 4.88 ± 3.01 , p = 0.009 ) and increased lag time for U46619 ( 00:16 ± 00:00 vs. 00:29 ± 00:07 s , p = 0.018 ) induced platelet aggregation . Thus , 4-week supplementation of 640 mg omega-3 PUFA reduced measures of platelet aggregation and activation in healthy subjects but effects were less evident in patients with existing CVD . Our findings support the recommendation that the omega-3 PUFA dose be higher in CVD than among healthy subjects Blood pressure is a heritable determinant of cardiovascular disease ( CVD ) risk . Recent genome-wide association studies have identified several single-nucleotide polymorphisms ( SNPs ) associated with blood pressure , including rs1378942 in the c-Src tyrosine kinase ( CSK ) gene . Fish oil supplementation provides inconsistent protection from CVD , which may reflect genetic variation . We investigated the effect of rs1378942 genotype interaction with fish oil dosage on blood pressure measurements in the MARINA ( Modulation of Atherosclerosis Risk by Increasing doses of N-3 fatty Acids ) study , a parallel , double-blind , controlled trial in 367 participants r and omly assigned to receive treatment with 0.45 , 0.9 , and 1.8 g/d eicosapentaenoic acid [ EPA ( 20:5n-3 ) ] and docosahexaenoic acid [ DHA ( 22:6n-3 ) ] ( 1.51:1 ) or an olive oil placebo for 12 mo . A total of 310 participants were genotyped . There were no significant associations with blood pressure measures at baseline ; however , the interaction between genotype and treatment was a significant determinant of systolic blood pressure ( SBP ) ( P = 0.010 ) , diastolic blood pressure ( DBP ) ( P = 0.037 ) , and mean arterial blood pressure ( MABP ) ( P = 0.014 ) . After the 1.8 g/d dose , noncarriers of the rs1378942 variant allele showed significantly lower SBP ( P = 0.010 ) , DBP ( P = 0.016 ) , and MABP ( P = 0.032 ) at follow-up , adjusted for baseline values , than did carriers . We found no evidence of SNP genotype association with endothelial function ( brachial artery diameter and flow-mediated dilatation ) , arterial stiffness ( carotid-femoral pulse wave velocity and digital volume pulse ) , and resting heart rate . A high intake of EPA and DHA could help protect noncarriers but not carriers of the risk allele . Dietary recommendations to reduce blood pressure in the general population may not necessarily benefit those most at risk . This trial was registered at controlled-trials.com as IS RCT N66664610 Objective We conducted a clinical trial to examine the effect of & ohgr;-3 fatty acids in patients with cardiac syndrome X ( CSX ) . We aim ed to evaluate the potential impact of & ohgr;-3 fatty acids on endothelial function , oxidative stress , and symptom relief in the CSX . Methods and results Eighteen patients with CSX were enrolled according to a double-blind , r and omized , placebo-controlled design . Patients were r and omized to & ohgr;-3 fatty acids ( 1440 mg/day , n=8 ) or placebo ( n=10 ) for 4 months . We assessed plasma levels of malondialdehyde ( MDA ) , endothelium-dependent vasodilatation [ flow-mediated dilatation ( FMD ) ] , endothelium-independent vasodilatation [ nitroglycerin-mediated dilatation ( NMD ) ] , and status of symptom [ score with Seattle Angina Question naire ( SAQ ) ] before and after the treatment . After 4 months , patients who were treated with & ohgr;-3 fatty acids showed significant increases in the FMD ( from 47±48 to 104±23 % , P<0.05 ) and NMD ( from 51±53 to 93±35 % , P<0.05 ) values , and significant decreases in the plasma MDA levels ( 4.4±0.86 to 3.35±0.33 µmol/l , P=0.012 ) . SAQ scores were increased significantly in both groups ( from 60±14 to 73±15 % , P<0.05 placebo , from 67±10 to 81±9 % , P<0.05 treatment group ) . NMD was correlated negatively with the plasma MDA levels . Conclusion Four months of therapy with a moderate dose of & ohgr;-3 fatty acids improved the endothelial function and reduced oxidative stress in patients with CSX BACKGROUND AND AIMS To compare the effects of n-3 long chain polyunsaturated fatty acids ( n-3 LCPUFA ) , with those of fenofibrate , on markers of inflammation and vascular function , and on the serum lipoprotein profile in overweight and obese subjects . METHODS AND RESULTS Twenty overweight and obese subjects participated in a r and omized , double-blind , placebo-controlled intervention trial and received 3.7 g/d n-3 fatty acids ( providing 1.7 g/d EPA and 1.2 g/d DHA ) , 200 mg fenofibrate or placebo treatment for 6 weeks separated by a 2 weeks wash-out period . Fish oil and fenofibrate treatment reduced triglyceride ( -0.61 ± 0.81 mmol/L , P < 0.001 , and -0.34 ± 0.85 mmol/L , P = 0.048 , respectively ) and increased HDL cholesterol concentrations ( 0.13 ± 0.21 mmol/L , P = 0.013 , and 0.10 ± 0.18 mmol/L , P = 0.076 ) , as reflected by a decrease of large very VLDL particles and increases of large HDL particles and medium size HDL particles . Fish oil increased serum LDL cholesterol concentrations ( 0.34 ± 0.59 mmol/L , P = 0.013 ) . Fenofibrate reduced concentrations of soluble endothelial selectin ( sE-selectin ) ( -4.1 ± 7.5 ng/mL , P = 0.032 ) , but increased those of macrophage chemoattractant protein 1 ( MCP1 ) ( 28 ± 55 ng/mL , P = 0.034 ) . Fish oil had no effects on these markers . CONCLUSION Although n-3 LCPUFA and fenofibrate can both activate PPARα , they have differential effects on cardiovascular risk markers . In overweight and obese subjects fenofibrate ( 200 mg/d ) or n-3 LCPUFA ( 3.7 g/d ) treatment for 6 weeks did not improve markers for low- grade systemic inflammation , while fenofibrate had more profound effects on plasma lipids and markers for vascular activity compared to fish oil . Registration number clinical trials EudraCT 2006 - 005743 - 28 OBJECTIVES : Impaired fetal growth is an independent cardiovascular risk factor and is associated with arterial wall thickening in children . No preventive strategy has been identified . We sought to determine whether dietary omega-3 fatty acid supplementation during early childhood prevents the association between impaired fetal growth and carotid arterial wall thickening . METHODS : The Childhood Asthma Prevention Study was a r and omized , controlled single-blind trial in 616 children born at term , recruited antenatally from maternity hospitals in Sydney . Participants were r and omized to either a 500-mg-daily fish oil supplement and canola-based margarines and cooking oil ( omega-3 group ) , or a 500-mg-daily sunflower oil supplement and omega-6 fatty acid – rich margarines and cooking oil ( control group ) , from the start of bottle-feeding or 6 months of age until 5 years of age . Carotid intima-media thickness ( IMT ) , a noninvasive measure of sub clinical atherosclerosis , was the primary endpoint of a cardiovascular sub study ( CardioCAPS ) at age 8 years . We examined the association of fetal growth with carotid IMT in children with birth weight < 90th percentile ( omega-3 group [ n = 187 ] , control group [ n = 176 ] ) . RESULTS : In the control group , fetal growth was inversely associated with carotid IMT , but this was prevented in the omega-3 group ( difference between groups of 0.041 mm [ 95 % confidence interval 0.006 , 0.075 ] per kg birth weight , adjusted for gestational age and gender , Pheterogeneity = .02 ) . CONCLUSIONS : The inverse association of fetal growth with arterial wall thickness in childhood can be prevented by dietary omega-3 fatty acid supplementation over the first 5 years of life OBJECTIVES Cardiovascular disease and osteoporosis are common in HIV-infected patients and residual systemic inflammation is thought to contribute to both of these disorders . We performed a r and omized placebo-controlled trial of omega-3-acid ( O3A ) ethyl esters in HIV-infected patients with hypertriglyceridaemia , hypothesizing that O3A would decrease serum levels of triglycerides , markers of systemic inflammation , and markers of bone turnover . METHODS HIV-infected patients ( n = 48 recruited at three sites ) with CD4 count > 200 cells/μL , suppressed viral load , and triglycerides > 200 mg/dL were r and omized to placebo or 3.6 g/d of O3A .  Fasting lipid profiles and markers of inflammation and bone turnover were assessed at baseline and after 8 weeks of treatment . RESULTS Baseline HIV status , lipid profile , bone metabolism and cardiovascular risk factors were similar between the groups . Inflammatory markers were similar between the treatment groups at baseline , except for interleukin (IL)-6 and tumour necrosis factor (TNF)-α , which were higher in the O3A group . The concentration of triglycerides in patients receiving O3A decreased by a median ( interquartile range ( IQR ) ) of -34 ( -149 , 9.5 ) mg/dL vs. a median increase of 46.5 ( -51 , 123 ) mg/dL in the placebo group ( P = 0.01 ) . The median percentage change in IL-6 was greater in the O3A group compared with the placebo group [ -39 % ( -63 , 12 % ) vs. 29 % ( 10 , 177 % ) , respectively ; P = 0.006 ] . Similar results were observed for TNF-α , but not other inflammatory or bone turnover markers . CONCLUSIONS O3A ethyl esters decreased the concentrations of triglycerides , IL-6 and TNF-α in patients with well-controlled HIV infection and hypertriglyceridaemia . Larger studies are required to confirm these findings and investigate their clinical significance OBJECTIVE Epidemiologic studies suggest that elevated postpr and ial triglycerides ( ppTG ) are associated with future cardiovascular events . Monocyte activation plays an important role in vascular diseases . Omega-3 fatty acids ( n3-FA ) lower fasting TG levels . The effects of n3-FA on ppTG and the role of ppTG for monocyte activation are insufficiently understood . METHODS AND RESULTS 23 healthy volunteers and 30 non-diabetic patients with documented coronary artery disease were subjected to an oral TG tolerance test ( OTTT ) consisting of 80 g cream fat or to water as control ( H(2)O ) . Patients were treated with 4 g n3-FA/day or placebo for 3 weeks in a r and omized , placebo-controlled , double-blind , crossover study . Relative postpr and ial TG increase reached its maximum 4 h after fat intake ( 185.1 ± 10.9 % of baseline ) . n3-FA reduced fasting TG from 137.1 ± 12.9 to 112.2 ± 8.6 mg/dl ( p < 0.05 ) , and maximum ppTG concentrations from 243.6 ± 24.6 to 205.8 ± 17.1 mg/dl ( p < 0.05 ) , while relative TG increase ( 192.8 ± 12.7 % ) was comparable to placebo . Relative monocytopenia and neutrophilia were detected following fat intake , which was unaffected by n3-FA and also detectable in the H(2)O group . Serum chemotactic cytokine ( MCP1 and fractalkine ) concentrations and monocyte migration were not affected by fat intake or n3-FA . Monocyte activation markers CD11b and CD14 , monocyte sub population s CD16(+)CD14(high ) and CD16(+)CD14(low ) , sICAM serum levels and markers of oxidative stress remained unchanged by fat intake or n3-FA . CONCLUSION The postpr and ial TG increase does not stimulate monocytes beyond their circadian activation patterns . n3-FA reduce fasting TG and the postpr and ial TG increase . n3-FA may therefore allow to prospect ively study whether selected patients benefit from TG-lowering independent of LDL- and HDL-cholesterol Hypertriglyceridemia and low high-density lipoprotein (HDL)-cholesterol ( HDL-C ) may contribute to a presumed accelerated risk for cardiovascular disease in HIV-infected individuals . We evaluated the effect of omega-3 fatty acid treatment on triglycerides , low-density lipoprotein (LDL)-C , HDL-C , and HDL sub population s. Forty-one HIV-seropositive subjects with hypertriglyceridemia ( ≥150 mg/dl ) on active antiretroviral therapy were enrolled in this placebo-controlled , double-blind , r and omized , crossover trial comparing the effects of omega-3 fatty acid treatment ( 1.9 g EPA and 1.5 g DHA ) on triglycerides , LDL-C , HDL-C , and HDL sub population s. An independent sample t-test was used to assess the study start to posttreatment change for all components . After omega-3 fatty acid treatment , triglyceride levels decreased 63.2±86.9 mg/dl ( p<0.001 ) . No significant changes in total cholesterol , LDL-C , or HDL-C were found . Within HDL sub population s , significant changes were seen in the most atheroprotective HDL particles , α-1 , which increased by 2.5±5.6 mg/dl ( p<0.05 ) , and preα-1 , which increased by 0.6±1.0 mg/dl ( p<0.001 ) . Preα-3 , a presumably atherogenic HDL particle , decreased by 0.5±0.9 mg/dl ( p<0.01 ) . Omega-3 fatty acid treatment significantly lowered triglyceride levels in HIV-positive patients with moderate hypertriglyceridemia . While no study -wide improvements in LDL-C or HDL-C were detected , the HDL sub population profile changed in a beneficial way suggesting more cardioprotection after treatment OBJECTIVE The beneficial effects of fish and n-3 polyunsaturated fatty acids ( PUFAs ) consumption on atherosclerosis have been reported in numerous epidemiological studies . However , to the best of our knowledge , the effects of a fish-based diet intervention on endothelial function have not been investigated . Therefore , we studied these effects in postmenopausal women with type 2 diabetes mellitus ( T2DM ) . MATERIAL S/ METHODS Twenty-three postmenopausal women with T2DM were assigned to two four-week periods of either a fish-based diet ( n-3 PUFAs ≧ 3.0 g/day ) or a control diet in a r and omized crossover design . Endothelial function was measured with reactive hyperemia using strain-gauge plethysmography and compared with the serum levels of fatty acids and their metabolites . Endothelial function was determined with peak forearm blood flow ( Peak ) , duration of reactive hyperemia ( Duration ) and flow debt repayment ( FDR ) . RESULTS A fish-based dietary intervention  improved Peak by 63.7 % , Duration by 27.9 % and FDR by 70.7 % , compared to the control diet . Serum n-3 PUFA levels increased after the fish-based diet period and decreased after the control diet , compared with the baseline ( 1.49 vs. 0.97 vs. 1.19 mmol/l , p < 0.0001 ) . There was no correlation between serum n-3 PUFA levels and endothelial function . An increased ratio of epoxyeicosatrienoic acid/dihydroxyeicosatrienoic acid was observed after a fish-based diet intervention , possibly due to the inhibition of the activity of soluble epoxide hydrolase . CONCLUSIONS A fish-based dietary intervention  improves endothelial function in postmenopausal women with T2DM . Dissociation between the serum n-3 PUFA concentration and endothelial function suggests that the other factors may contribute to this phenomenon
Several studies and review s regarding the supplementation of omega-3 LC-PUFAs have been developed during the last years .
Indeed , the evidence states that high doses omega-3 LC-PUFAs produce a small but significant decrease in blood pressure in older and hypertensive subjects .
Due to the increasing interest in the benefits of LC-PUFAs , we aim ed to evaluate the scientific evidence provided in the past five years ( 2012 - 2016 ) on the effects of the intake of omega-3 LC-PUFAs on cardiovascular risk factors such as inflammation and oxidative stress , through a systematic review in PubMed data base .