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European Heart Journal 2001 22(5):428-436; doi:10.1053/euhj.2000.2369
Copyright © 2001 by the European Society of Cardiology.
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Omega-3 fatty acids improve blood pressure control and preserve renal function in hypertensive heart transplant recipients

T Holma,b,f1, A.K Andreassena, P Aukrustb,c, K Andersena, O.R Geirand, J Kjekshusa, S Simonsena and L Gullestada

a Department of Cardiology, University of Oslo, Rikshospitalet, N-0027, Oslo, Norway
b Research Institute for Internal Medicine, University of Oslo, Rikshospitalet, N-0027, Oslo, Norway
d Department of Thoracic Surgery, University of Oslo, Rikshospitalet, N-0027, Oslo, Norway
c Section of Clinical Immunology and Infectious Diseases, Department of Medicine, University of Oslo, Rikshospitalet, N-0027, Oslo, Norway

Received May 28, 2000; accepted July 12, 2000

Abstract

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.

Methods and 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 3·4g of omega-3 fatty acids daily or placebo for 1 year. Ambulatory 24h blood pressure monitoring and haemodynamic studies were performed before randomization and at the end of the study. Systolic blood pressure increased by 8±3mmHg (P<0·01) in the placebo group, with a non-significant increase in diastolic blood pressure of 3±2mmHg (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.

Conclusion 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.

Key Words: Heart transplantation, hypertension, omega-3 fatty acids, kidney, endothelium

f1 Correspondence: Torbjøorn Holm, Institute for Internal Medicine, Rikshopitalet, Sognsvannsvn 20, N-0027 Oslo, Norway.

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