Effects of a fish-based diet and administration of pure eicosapentaenoic acid on brachial-ankle pulse wave velocity in patients with cardiovascular risk factors.
OBJECTIVE
Brachial-ankle pulse wave velocity (baPWV) and ratio of plasma eicosapentaenoic acid to arachidonic acid (EPA/AA ratio) are surrogate markers for coronary artery disease (CAD). We aimed to evaluate the effects of a fish-based diet and administration of EPA on baPWV and plasma EPA/AA ratio.


RESULTS
The changes in baPWV and plasma EPA/AA ratio were compared before and after a 6-month fish-based diet in 191 patients with cardiovascular risk factors. A fish-based diet resulted in significant increment of plasma EPA/AA ratio (0.40±0.18 vs. 0.49±0.27, p<0.001), with baPWV remaining unchanged. Multivariate analysis revealed that systolic blood pressure (SBP) (6-month SBP-baseline SBP) and CAD were positively associated with increased baPWV (CAD: odds ratio=2.040, p=0.0436, SPB: odds ratio=1.056, p=0.0003). When the patients were divided into three groups: CAD, low-risk, and high-risk with no prior history of CAD according to the number of risk factors at baseline, comparison among the three groups disclosed an inter-group difference in the magnitude of change in baPWV (low-risk: -35±164cm/s, high-risk: -14±190cm/s, CAD: 39±164cm/s, p=0.0071 for trend). In 191 patients who had received a 6-month fish-based diet, 21 patients (primarily CAD patients) sequentially received high purity EPA (1800mg/day) for 6 months. It resulted in marked increment of plasma EPA/AA ratio (0.65±0.57 vs. 1.19±0.46, p<0.001), accompanied by significant reduction in baPWV (1968±344cm/s vs. 1829±344cm/s, p=0.0061). There was a significant negative correlation between changes in baPWV and changes in plasma EPA/AA ratio in patients with a fish-based diet and sequential administration of EPA (r=-0.446, p=0.017).


CONCLUSIONS
A fish-based diet was effective against increased baPWV only in low-risk patients, with slight increment of plasma EPA/AA. In high-risk patients and CAD patients, administration of EPA for preventing progression of baPWV endorsed the validity of high purity EPA administration recommended in the current guidelines.
Department of Digestive and Life-style Related Diseases, Human Environmental Sciences, Health Research Studies, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan. Electronic address: dukuy2413@gmail.com.
Yoshihiro
Y
Fukuoka
Department of Digestive and Life-style Related Diseases, Human Environmental Sciences, Health Research Studies, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Norihito
N
Nuruki
Department of Digestive and Life-style Related Diseases, Human Environmental Sciences, Health Research Studies, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Shun
S
Amiya
Department of Digestive and Life-style Related Diseases, Human Environmental Sciences, Health Research Studies, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Katsunori
K
Tofuku
Saiseikai Sendai Hospital, Kagoshima, Japan.
Shinichiro
S
Aosaki
Department of Digestive and Life-style Related Diseases, Human Environmental Sciences, Health Research Studies, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Hirohito
H
Tsubouchi
D000368:Aged; D000818:Animals; D000842:Ankle / Q000098:blood supply*; D016718:Arachidonic Acid / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001916:Brachial Artery / Q000503:physiopathology*; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control*; D004032:Diet; D019587:Dietary Supplements; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D005396:Fish Products; D005399:Fishes; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D063177:Pulse Wave Analysis; D012307:Risk Factors
D015415:Biomarkers; D016718:Arachidonic Acid; D015118:Eicosapentaenoic Acid
Brachial-ankle pulse wave velocity; Coronary artery disease; Eicosapentaenoic acid; Fish-based diet; Ratio of plasma eicosapentaenoic acid to arachidonic acid (EPA/AA ratio)