Natural Products Chemistry & Research

ISSN - 2329-6836

Editorial - (2015) Volume 3, Issue 2

Omega -3 Fatty Acid for Cardiovascular Prevention

Pollen K Yeung*
College of Pharmacy and Department of Medicine, Dalhousie University, Halifax, NS, B3H 4R2, Canada
*Corresponding Author: Pollen K Yeung, Dalhousie University, Halifax, NS, B3H 4R2, Canada, Tel: 902-4943845, Fax: 902-4941396 Email:

Cardiovascular disease including stroke is one the leading cause of death and disability and an enormous economic burden to our societies. Based on the latest statistics released for heart and stroke disease, an estimated 83,600,000 adults in the United State (US) (>30%) have one or more types of cardiovascular disease (CVD) of whom more than 90% have hypertension, 18% have coronary heart disease (CHD), close to 10% have myocardial infarction (MI) and 8% have stroke. The total direct and indirect cost in the US alone for treatment of cardiovascular diseases (hospitalization, drugs, home healthcare, etc.) and loss of productivity and morbidity is estimated at close to $315 billion US per year [1]. Thus prevention by better diagnosis and improved treatment strategies could provide a huge saving for the health care cost worldwide. Despite advancement in modern cardiovascular medicine, the prevalence of hypertension, ischemic heart disease (IHD) and stroke is still on the rise particularly in industrialized societies and in the obese and elderly population, and that finding an optimum drug therapy to slow disease progression remains a therapeutic challenge.

In addition to diet and exercise, natural products and nutraceuticals are increasingly used in our societies to enhance health, slow down aging, and prevention of chronic diseases [2-5]. One of the most widely recognized natural health products which have potential cardiovascular protective effect is omega-3 fatty acid (Omega-3) [6-10]. Omega-3 is a polyunsaturated fatty acid (n-3 PUFAs) made up mainly of eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) in the form of fish oil, and alpha linolenic acid (ALA) if it is from plant source such as flaxseed oil [11,12]. Although there are evidences suggesting that EPA and DHA may have differing effects on cellular and cardiovascular functions, these differences are mostly quantitative and most studies do not differentiate their effects separately [13,14]. In general, Omega-3 influences the physical nature of cell membranes and membrane protein-mediated responses, eicosanoid generation, cell signaling and gene expression in many different cell types, and have an effect on glucose and lipid metabolism. It also has pleiotropic effects which include lowering of blood pressure, antiplatelet and anti-oxidant properties, improved endothelial function and increased high-density cholesterol levels [15-18]. These effects are often evidenced by improvements in disease biomarker profiles or in health-related outcomes. As a result, they may play an important role to protect against cardiovascular morbidity and mortality, and might be beneficial in rheumatoid arthritis, diabetes, inflammatory diseases, childhood learning and behaviour, cancer prevention, and adult psychiatric and neurodegenerative illnesses [7,19-24]. It has been shown recently that Omega-3 can protect myocardial infarction (MI) from ischemia/reperfusion injury in an isolated rat heart model [25] and promote early metabolic recovery after coronary artery bypass grafting (CABG) surgery [26]. However, despite the abundance of evidences to support the potential of Omega-3 for cardiovascular protection in experimental models, the protective effects have not been confirmed unequivocally by controlled clinical trials which could be related to factors such as inadequate power in the studies, inadequate exposure to Omga-3, and patient heterogeneity [27]. There are also evidence to suggest that Omega-3 may enhance the therapeutic effects of conventional medicines for hyperlipidemias [28], although solid data supporting or against use of the combinations are very limited. While the mechanism for protective effects of these natural health products are not fully understood, they could be related to their antioxidant, anti-inflammatory and anti-ischemia properties [18,23,24,29] which are important contributing factors for ischemia preconditioning and cardiovascular protection. Furthermore, there are evidence to suggest that DHA may inhibit first pass metabolism by cytochrome P-450 isozymes (CYP450), which could enhance oral drug absorption and improve safety and efficacy profiles of many cardiovascular drugs [30,31] and that they may be incorporated in traditional cardiovascular drug therapies. Thus in view of the increasing use of Omega-3 and other natural health products in North America and around the world to enhance cardiovascular health, and the sparsity of information available for possible interaction with prescription medications, there is an urgent need for more mechanistic research to study the cardiovascular effect of Omega-3 and its combinations with traditional medicines to justify their role for cardiovascular protection and prevention in complementary medicine.

In summary it is conceivable Omega-3 has significant potential for cardiovascular prevention as a stand-alone nutritional supplement and as an adjunct to complement the therapeutic effect of traditional cardiovascular medicines. However, there are a number of challenges which need to be overcome in order to exploit the full potential of Omega-3 in cardiovascular prevention and in complementary medicine. First clinical trials to study the cardiovascular effects of Omega-3 should be designed to understand the mechanism behind the health benefits and has adequate power to answer the underlying question. Secondly, there is a need for identifying systemic biomarkers which can be implemented in both experimental animal studies and clinical trials to assess the cardiovascular health benefits of Omega-3 [32]. Thirdly, despite its promising potential for health management, there is a need for better understanding of the importance of Omega-3 and other anti-oxidants in mitochondrial energetic and whole body energy metabolism in disease management, and their contribution to the safety and effectiveness of traditional cardiovascular medicines. Finally, more data on the long-term safety and the true costeffectiveness and risk-benefit ratio of Omega-3 will further advance our knowledge of using the natural product as a potential therapeutic agent for widespread use in a general population and for management of CVD.

References

  1. Go AS, Dariush M, Véronique L, Emelia JB, Jarett DB, et al. (2014) Heart disease and stroke statistics - 2014 update: a report from the American Heart Association.Circulation129:e28–e292.
  2. Lee JH,Jarreau T, Prasad A, Lavie C, O'Keefe J, et al. (2011) Nutritional assessment in heart failure patients. Congest Heart Fail 17: 199-203.
  3. Cicero AF,Borghi C (2013) Evidence of clinically relevant efficacy for dietary supplements and nutraceuticals. CurrHypertens Rep 15: 260-267.
  4. Sapre S, Thakur R (2014) Lifestyle and dietary factors determine age at natural menopause. J Midlife Health 5: 3-5.
  5. Allison DB, Antoine LH, Ballinger SW, Bamman MM, Biga P, et al. (2014) Aging and energetics' 'Top 40' future research opportunities 2010-2013. F1000Res 3: 219.
  6. Lorente-Cebrián S, Costa AG, Navas-Carretero S, Zabala M, Martínez JA, et al. (2013) Role of omega-3 fatty acids in obesity, metabolic syndrome, and cardiovascular diseases: a review of the evidence. J PhysiolBiochem 69: 633-651.
  7. Fares H,Lavie CJ, DiNicolantonio JJ, O'Keefe JH, Milani RV (2014) Omega-3 fatty acids: a growing ocean of choices. CurrAtheroscler Rep 16: 389.
  8. DiNicolantonio JJ,Niazi AK, McCarty MF, O'Keefe JH, Meier P, et al. (2014) Omega-3s and cardiovascular health. Ochsner J 14: 399-412.
  9. Kromhout D, de Goede J (2014) Update on cardiometabolic health effects of w-3 fatty acids. CurrOpinLipidol 25: 85-90.
  10. Sanders TA (2014) Protective effects of dietary PUFA against chronic disease: evidence from epidemiological studies and intervention trials. ProcNutrSoc 73: 73-79.
  11. Calder PC,Yaqoob P (2009) Omega-3 polyunsaturated fatty acids and human health outcomes. Biofactors 35: 266-272.
  12. Rodriguez-Leyva D,Dupasquier CM, McCullough R, Pierce GN (2010) The cardiovascular effects of flaxseed and its omega-3 fatty acid, alpha-linolenic acid. Can J Cardiol 26: 489-496.
  13. Gorjão R,Azevedo-Martins AK, Rodrigues HG, Abdulkader F, Arcisio-Miranda M, et al. (2009) Comparative effects of DHA and EPA on cell function. PharmacolTher 122: 56-64.
  14. Kelley DS, Adkins Y (2012) Similarities and differences between the effects of EPA and DHA on markers of atherosclerosis in human subjects. ProcNutrSoc 71: 322-331.
  15. Papazafiropoulou AK,Kardara MS, Pappas SI (2012) Pleiotropic effects of omega-3 fatty acids. Recent Pat EndocrMetab Immune Drug Discov 6: 40-46.
  16. Burillo E, Martín-Fuentes P, Mateo-Gallego R, Baila-Rueda L, Cenarro A, et al. (2012) Omega-3 fatty acids and HDL. How do they work in the prevention of cardiovascular disease? CurrVascPharmacol 10: 432-441.
  17. Brinson BE, Miller S (2012) Fish oil: what is the role in cardiovascular health? J Pharm Pract 25: 69-74.
  18. Wachira JK, Larson MK, Harris WS (2014) n-3 Fatty acids affect haemostasis but do not increase the risk of bleeding: clinical observations and mechanistic insights. Br J Nutr 111: 1652-1662.
  19. Calder PC (2012) The role of marine omega-3 (n-3) fatty acids in inflammatory processes, atherosclerosis and plaque stability. MolNutr Food Res 56: 1073-1080.
  20. Swanson D, Block R, Mousa SA (2012) Omega-3 fatty acids EPA and DHA: health benefits throughout life. AdvNutr 3: 1-7.
  21. Kromhout D, Yasuda S, Geleijnse JM, Shimokawa H (2012) Fish oil and omega-3 fatty acids in cardiovascular disease: do they really work? Eur Heart J 33: 436-443.
  22. Murray M,Hraiki A,Bebawy M,Pazderka C,Rawling T (2015) Anti-tumor activities of lipids and lipid analogues and their development as potential anticancer drugs.PharmacolTher.
  23. Grosso G,Galvano F,Marventano S,Malaguarnera M,Bucolo C, et al. (2014) Omega-3 fatty acids and depression: scientific evidence and biological mechanisms. Oxid Med Cell Longev 2014: 313570.
  24. Yates CM, Calder PC, Ed Rainger G3 (2014) Pharmacology and therapeutics of omega-3 polyunsaturated fatty acids in chronic inflammatory disease. PharmacolTher 141: 272-282.
  25. Richard D,Oszust F, Guillaume C,Millart H, Laurent-Maquin D, et al. (2014) Infusion of docosahexaenoic acid protects against myocardial infarction. Prostaglandins LeukotEssent Fatty Acids 90: 139-143.
  26. VeljoviÄ M,PopadiÄ A, VukiÄ Z, IliÄ R, TrifunoviÄ Z, et al. (2013) Myocardial protection during elective coronary artery bypasses grafting by pretreatment with omega-3 polyunsaturated fatty acids. Vojnosanit Pregl 70: 484-492.
  27. Harris WS1 (2013) Are n-3 fatty acids still cardioprotective? CurrOpinClinNutrMetab Care 16: 141-149.
  28. Maki KC,McKenney JM, Reeves MS, Lubin BC, Dicklin MR (2008) Effects of adding prescription omega-3 acid ethyl esters to simvastatin (20 mg/day) on lipids and lipoprotein particles in men and women with mixed dyslipidemia. Am J Cardiol 102: 429-433.
  29. Rosenfeldt F,Marasco S, Lyon W, Wowk M, Sheeran F, et al. (2005) Coenzyme Q10 therapy before cardiac surgery improves mitochondrial function and in vitro contractility of myocardial tissue. J ThoracCardiovascSurg 129: 25-32.
  30. Hirunpanich V, Sato H (2006) Docosahexaenoic acid (DHA) inhibits saquinavir metabolism in-vitro and enhances its bioavailability in rats. J Pharm Pharmacol 58: 651-658.
  31. MacDonald L, Foster BC, Akhtar H (2009) Food and therapeutic product interactions - a therapeutic perspective. J Pharm PharmSci 12: 367-377.
  32. Silva V,Barazzoni R, Singer P (2014) Biomarkers of fish oil omega-3 polyunsaturated fatty acids intake in humans. NutrClinPract 29: 63-72.
Citation: Yeung PK (2015) Omega -3 Fatty Acid for Cardiovascular Prevention. Nat Prod Chem Res 3:e111.

Copyright: © 2015 Yeung PK. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.