REPEATED FASTING AND REFEEDING WITH 20 5, N-3 EICOSAPENTAENOIC ACID (EPA) - A NOVEL-APPROACH FOR RAPID FATTY-ACID EXCHANGE AND ITS EFFECT ON BLOOD-PRESSURE, PLASMA-LIPIDS AND HEMOSTASIS/

Twenty hypertensive subjects participated in three clinical trials of 13 days each, to examine the effects of Alsepa fish oil [20:5, n-3 eic osapentaenoic acid (EPA) 180 mg, and 22:6 n-3 docosahexaenoic acid (DH A) 120 mg] on n-3 for n-6 polyunsaturated fatty acids (PUFA) exchange on serum phospholipids, blood pressure (BP), triglycerides (To) and pr imary hemostasis. After 13 days, plasma phospholipids showed an increa se in Sigma n-3 (EPA and DHA) from 2.0 to 5.9 % (P < 0.01), and a decr ease in Sigma n-6 (arachidonic acid and linoleic acid) from 29.8 to 22 .6 % (P < 0.01). A concomitantly significant reduction in systolic BP (SEP) (158.7 +/- 23.8 mm Hg to 146.5 +/- 17.0 mm Hg, P = 0.04), and di astolic BP (DBP) (80.8 +/- 8.4 mm Hg to 72.9 +/- 14.9 mm Hg, P = 0.04) as well as a significant decrease in platelet adhesion and aggregatio n on extra cellular matrix measured as a percentage of surface coverag e (11.9 +/- 4.8 % to 4.2 +/- 3.2 %, P = 0.0001) was observed. In addit ion, a significant reduction in baseline dependent To was observed; th e higher the baseline level To, the more pronounced the reduction (ave rage 159.2 +/- 74.6 mg% to 108.0 +/- 46.1 mg%, P = 0.001). No change w as observed in total cholesterol, high and low density lipoprotein (HD L, LDL), platelet and fibrinogen. Repeated fasting and refeeding with fish oil facilitated plasma exchange of n-3 for n-6 PUFA, improved BP, clinical metabolic parameters and lowered platelet reactivity in the vessel wall (primary hemostasis). In severe and life-threatening situa tions, the beneficial effects of fish oil should be considered for rap id exchange of n-3 for n-6 PUFA. In this study we describe a novel app roach for rapid fatty acid exchange by fasting/refeeding with fish oil supplementation, as well as improved BP, plasma lipids and primary he mostasis. Further research is required on the therapeutic use of fish oils and the physiological mechanisms involved in fatty acid exchange.