Effect of omega-3 fatty acids on heart rate variability in depressed patients with coronary heart disease.
OBJECTIVE
To determine whether omega-3 fatty acid (FA) increases the natural log of very low frequency (lnVLF) power, an index of heart rate variability (HRV), and reduces 24-hour heart rate (HR) in depressed patients with coronary heart disease (CHD). Low intake of omega-3 FAs is associated with depression and with low HRV, and all three are associated with an increased risk of death in patients with CHD.


METHODS
Thirty-six depressed patients with CHD randomized to receive 50 mg of sertraline and 2 g of omega-3/day, and 36 randomized to sertraline and a placebo, had 24-hour HRV measured at baseline and after 10 weeks of treatment.


RESULTS
There was a significant treatment × time interaction for covariate adjusted lnVLF (p = .009), for mean 24-hour HR (p = .03), and for 1-minute resting HR (p = .02). The interaction was not significant for three other measures of HRV. LnVLF did not change over time in the omega-3 arm but decreased in the placebo arm (p = .002), suggesting that omega-3 may have prevented or slowed deterioration in cardiac autonomic function.


CONCLUSIONS
The effects of omega-3 FAs on lnVLF and HR, although modest, were detected after only 10 weeks of treatment with 2 g per day of omega-3. Whether a longer course of treatment or a higher dose of omega-3 would further decrease HR, improve other indices of HRV, or reduce mortality in depressed CHD patients should be investigated.
Carney
Robert M
RM
Behavioral Medicine Center, Department of Psychiatry, Washington University School of Medicine, 4320 Forest Park Avenue, Suite 301, St. Louis, MO 63108, USA. carneyr@bmc.wustl.edu
Freedland
Kenneth E
KE
Stein
Phyllis K
PK
Steinmeyer
Brian C
BC
Harris
William S
WS
Rubin
Eugene H
EH
Krone
Ronald J
RJ
Rich
Michael W
MW
D002940:Circadian Rhythm / Q000187:drug effects; D015897:Comorbidity; D003327:Coronary Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D004359:Drug Therapy, Combination; D015716:Electrocardiography, Ambulatory / Q000187:drug effects / Q000706:statistics & numerical data; D015525:Fatty Acids, Omega-3 / Q000494:pharmacology* / Q000627:therapeutic use*; D005260:Female; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy; D010919:Placebos; D020280:Sertraline / Q000627:therapeutic use; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3; D010919:Placebos; D020280:Sertraline