The effects of [omega]3 fatty acids and coenzyme Q10 on blood pressure and heart rate in chronic kidney disease: a randomized controlled trial.
OBJECTIVE
Chronic kidney disease (CKD) associates with increased cardiovascular disease (CVD) risk. Hypertension is a major determinant of progression of CKD. Omega-3 fatty acids (omger3FA) protect against CVD via improvements in blood pressure, heart rate, vascular reactivity and serum lipids. Coenzyme Q(10) (CoQ) may improve blood pressure and vascular function. This study determined whether omega3FA and CoQ have independent or additive effects in improving the cardiovascular profile, particularly blood pressure and heart rate, in nondiabetic patients with CKD stages 3-4.


METHODS
In a double-blind, placebo-controlled intervention, patients were randomized to either omega3FA (4 g), CoQ (200 mg), both supplements or control (4 g), daily for 8 weeks.


RESULTS
Eighty-five patients aged 56.5 +/- 1.4 years; BMI 27.3 +/- 0.5 kg/m(2); supine blood pressure 125.0/72.3mmHg; and glomerular filtration rate 35.8 +/- 1.2 ml/min/1.73m(2), were randomized. Seventy-four completed the study. omega3FA, but not CoQ, reduced 24-h ambulatory heart rate (P<0.0001) and blood pressure (P<0.0001). Main effects for omega3FA on 24-h measurements were -3.3 +/- 0.7/ -2.9 +/- 0.5mmHg and -4.0 +/- 0.5 bpm. Postintervention blood pressure showed significant interactions between treatments. omega3FA reduced triglycerides 24% (P<0.001). There were no changes in glomerular filtration rate, urinary albumin or total protein excretion, cholesterol, HDL-cholesterol (C), LDL-C, glucose, insulin, or high-sensitivity C-reactive protein.


CONCLUSIONS
This study has shown that omega3FA reduce blood pressure, heart rate and triglycerides in patients with CKD. CoQ had no independent effect on blood pressure but increased heart rate. These results show that omega3FA lower blood pressure and may reduce cardiovascular risk in nondiabetic patients with moderate-to-severe CKD.
Mori
Trevor A
TA
University of Western Australia and the Cardiovascular Research Centre, Perth, Western Australia. trevor.mori@uwa.edu.au
Burke
Valerie
V
Puddey
Ian
I
Irish
Ashley
A
Cowpland
Christine A
CA
Beilin
Lawrence
L
Dogra
Gursharan
G
Watts
Gerald F
GF
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications; D001158:Arteries / Q000187:drug effects; D001786:Blood Glucose / Q000378:metabolism; D001792:Blood Platelets / Q000378:metabolism; D001794:Blood Pressure / Q000187:drug effects; D004032:Diet; D004311:Double-Blind Method; D004357:Drug Synergism; D050171:Dyslipidemias / Q000150:complications / Q000517:prevention & control*; D004452:Echocardiography; D005227:Fatty Acids / Q000378:metabolism; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000517:prevention & control*; D007328:Insulin / Q000097:blood; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010743:Phospholipids / Q000378:metabolism; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000652:urine; D014451:Ubiquinone / Q000378:metabolism / Q000494:pharmacology / Q000627:therapeutic use*
D001786:Blood Glucose; D005227:Fatty Acids; D015525:Fatty Acids, Omega-3; D007328:Insulin; D010743:Phospholipids; D014451:Ubiquinone