Omega-3 fatty acids in cardiovascular health

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Why are omega-3’s important?

Omega-3 fatty acids, in particular DHA and EPA, are widely known as important, naturally occurring compounds that offer significant protection to the cardiovascular system.

They work together to provide the building blocks needed to support healthy blood vessel and heart muscle function, and to balance fatty acids and cholesterol around the body.

EPA has been shown to help stabilise atherosclerotic plaques [1, 2], meaning that they are less likely to break apart and lead to blood vessel blockages in important organs, such as the heart, brain or lungs. While deficiencies in DHA have been linked with functional abnormalities of the heart muscle (known as the myocardium) [3].

Age-related risks

After the age of 65, there is an increase in the risk of cardiovascular problems, such as high blood pressure and heart problems [4], and these are also connected to a lower omega-3 level.

One study has found that elderly adults with heart disease and lower omega-3 levels had more telomere shortening, a genetic indicator of age-related tissue damage. In contrast, this marker was reversed when omega-3 status was more healthy, and suggests that omega-3’s are involved in healthy cardiovascular ageing.

What does the evidence say?

In a research study involving over 1500 people, it has been found that increases in EPA and DHA levels in the body were associated with lower levels of cardiovascular disease and improved blood cholesterol [5].

Collective analysis of 86 of these types of studies (with over 16,000 total subjects) has revealed that there is a modest improvement in overall health associated with EPA/DHA consumption, however typical doses (>400mg) can reduce the risk of coronary heart disease and elevated blood cholesterol by about 15% [6].

Lowering of blood cholesterol and lipids is an important component towards optimal cardiovascular health, but the function of the blood vessels and heart muscle is also very important.

Other studies have shown that EPA/DHA supplementation can enhance blood vessel dilation [7] and elasticity [8], assist in the regulation of a healthy blood pressure [9, 10] and reduce vascular inflammation [10].

In addition to this, EPA and DHA also supports heart muscle function by way of promoting normal cardiac rhythms [11, 12], reducing oxidative stress [12] and preserving the pumping ability of the heart [13].

References

  1. Cawood, A.L., et al., Eicosapentaenoic acid (EPA) from highly concentrated n-3 fatty acid ethyl esters is incorporated into advanced atherosclerotic plaques and higher plaque EPA is associated with decreased plaque inflammation and increased stability. Atherosclerosis, 2010. 212(1): p. 252-259.
  2. Zampelas, A., Eicosapentaenoic acid (EPA) from highly concentrated n-3 fatty acid ethyl esters is incorporated into advanced atherosclerotic plaques and higher plaque EPA is associated with decreased plaque inflammation and increased stability. Atherosclerosis., 2010. 212(1): p. 34-5. doi: 10.1016/j.atherosclerosis.2010.06.018. Epub 2010 Jul 1.
  3. Rupp, H., et al., Mechanisms involved in the differential reduction of omega-3 and omega-6 highly unsaturated fatty acids by structural heart disease resulting in “HUFA deficiency”. Can J Physiol Pharmacol., 2012. 90(1): p. 55-73. doi: 10.1139/y11-101. Epub 2011 Dec 21.
  4. https://www.nia.nih.gov/health/heart-health-and-aging.
  5. Block, R.C., et al., EPA and DHA in blood cell membranes from acute coronary syndrome patients and controls. Atherosclerosis., 2008. 197(2): p. 821-8. doi: 10.1016/j.atherosclerosis.2007.07.042. Epub 2007 Sep 17.
  6. Abdelhamid, A.S., et al., Omega-3 fatty acids for the primary and secondary prevention of cardiovascular disease. Cochrane Database Syst Rev., 2020. 3:CD003177.(doi): p. 10.1002/14651858.CD003177.pub5.
  7. Mizia-Stec, K., et al., N-3 Polyunsaturated fatty acid therapy improves endothelial function and affects adiponectin and resistin balance in the first month after myocardial infarction. Archives of medical science : AMS, 2011. 7(5): p. 788-795.
  8. Nestel, P., et al., The n-3 fatty acids eicosapentaenoic acid and docosahexaenoic acid increase systemic arterial compliance in humans. Am J Clin Nutr., 2002. 76(2): p. 326-30. doi: 10.1093/ajcn/76.2.326.
  9. Colussi, G., et al., Impact of omega-3 polyunsaturated fatty acids on vascular function and blood pressure: Relevance for cardiovascular outcomes. Nutrition, Metabolism and Cardiovascular Diseases, 2017. 27(3): p. 191-200.
  10. Guo, X.F., et al., Effects of EPA and DHA on blood pressure and inflammatory factors: a meta-analysis of randomized controlled trials. Crit Rev Food Sci Nutr, 2019. 59(20): p. 3380-3393. doi: 10.1080/10408398.2018.1492901. Epub 2019 Feb 4.
  11. Kirkegaard, E., et al., Marine n-3 fatty acids, atrial fibrillation and QT interval in haemodialysis patients. British Journal of Nutrition, 2012. 107(6): p. 903-909.
  12. Rodrigo, R., et al., Ageing improves the antioxidant response against postoperative atrial fibrillation: a randomized controlled trial. Interact Cardiovasc Thorac Surg, 2012. 15(2): p. 209-14.
  13. Maffei, S., et al., Effects of ω-3 PUFAs supplementation on myocardial function and oxidative stress markers in typical Rett syndrome. Mediators Inflamm, 2014. 2014: p. 983178.
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