Omega-3 fatty acids improve blood pressure control and preserve renal function in hypertensive heart transplant recipients.
BACKGROUND
Hypertension and cyclosporine-induced nephrotoxicity are common complications in heart transplant recipients. Omega-3 fatty acids may prevent blood pressure rise early, but have not been studied long-term after heart transplantation.


RESULTS
Forty-five clinically stable hypertensive heart transplant recipients were studied 1-12 years after transplantation and randomized in a double-blind fashion to receive either 3.4 g of omega-3 fatty acids daily or placebo for 1 year. Ambulatory 24 h blood pressure monitoring and haemodynamic studies were performed before randomization and at the end of the study. Systolic blood pressure increased by 8+/-3 mmHg (P<0.01) in the placebo group, with a non-significant increase in diastolic blood pressure of 3+/-2 mmHg (P=0.10), accompanied by a 14% increase in systemic vascular resistance (P<0.05). In contrast, no change in blood pressure or systemic vascular resistance was recorded in the omega-3 group. Plasma creatinine increased (P<0.01) and glomerular filtration rate decreased (P<0.05) in the placebo group, while no changes were observed in the omega-3 group. The antihypertensive effect was related to an increase in serum eicosapentaenoic and docosahexaenoic acid.


CONCLUSIONS
Treatment with omega-3 fatty acids may reduce the long-term continuous rise in blood pressure after heart transplantation and may offer a direct or indirect renoprotective effect, making these fatty acids a potentially attractive treatment for post-transplant hypertension.
Holm
T
T
Department of Cardiology, University of Oslo, Rikshospitalet, N-0027 Oslo, Norway.
Andreassen
A K
AK
Aukrust
P
P
Andersen
K
K
Geiran
O R
OR
Kjekshus
J
J
Simonsen
S
S
Gullestad
L
L
D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D003404:Creatinine / Q000097:blood; D004311:Double-Blind Method; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D007668:Kidney / Q000098:blood supply / Q000502:physiology; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3; D003404:Creatinine