Cyclosporine-induced hypertension. Efficacy of omega-3 fatty acids in patients after cardiac transplantation.
BACKGROUND
Cyclosporine-induced hypertension may be related to vasoconstriction of the afferent arterioles in the glomeruli caused by changes in the prostaglandin profile. omega-3 Fatty acids have demonstrated vasodilatory properties related to a favorable effect in the prostaglandin profile. The purpose of this study was to evaluate the antihypertensive effects of oral supplementation with omega-3 fatty acids in cyclosporine-treated cardiac transplant recipients.


RESULTS
The study consisted of 20 orthotopic cardiac transplant recipients with hypertension who were prospectively randomized in a double-blind fashion to receive either omega-6 fatty acids (placebo group, n = 10) or omega-3 fatty acids (treatment group, n = 10). Blood pressure, systemic hemodynamics, two-dimensional guided M-mode and Doppler echocardiography, and laboratory values (serum creatinine, lipid profile) were recorded at baseline and at 12 weeks. The treatment group demonstrated a significant reduction in mean arterial pressure (120 +/- 7 versus 102 +/- 7 mm Hg; P = .0001) associated with a decrease in systemic vascular resistance (2107 +/- 45 versus 1426 +/- 60 dynes.sec.cm-5; P = .0001). No changes in indexes of left ventricular structure and function occurred, except for a modest decrease in deceleration time (211 +/- 10 versus 182 +/- 12 milliseconds; P = .05), an index of left ventricular diastolic function.


CONCLUSIONS
omega-3 Fatty acids (3 g/d) reduce blood pressure by decreasing systemic vascular resistance and, therefore, can be used as an adjuvant for the treatment of hypertension in cyclosporine-treated cardiac transplant recipients. Their vasodilatory effect may be related to a beneficial change in the prostaglandin profile.
Ventura
H O
HO
Department of Internal Medicine, Ochsner Clinic, New Orleans, LA 70121.
Milani
R V
RV
Lavie
C J
CJ
Smart
F W
FW
Stapleton
D D
DD
Toups
T S
TS
Price
H L
HL
D000959:Antihypertensive Agents / Q000627:therapeutic use; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000188:drug therapy* / Q000453:epidemiology; D007165:Immunosuppression Therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors
D000959:Antihypertensive Agents; D015525:Fatty Acids, Omega-3; D016572:Cyclosporine