The effect of fish oil on hypertension, plasma lipids and hemostasis in hypertensive, obese, dyslipidemic patients with and without diabetes mellitus

We have recently reported that dietary fish oil supplementation (n-3) polyu nsaturated fatty acid (PUFA) led to a reduction in blood pressure (BP) and serum triglycerides (TG), in addition to the normalization of the hypercoag ulable state in subjects with obesity, hypertension and dyslipidemia withou t diabetes mellitus (OHD-DM). The aim of the present study was to explore t he mechanism of this amelioration by comparing the previous results to thos e obtained from 19 subjects who, in addition to the conditions described ab ove, also suffer from diabetes mellitus (OHD+DM) and proteinuria, In both t he non-diabetic and diabetic groups, a similar reduction was observed in BP (from 158.7/80.8 to 146/72.9 mmHg, and from 157.6/83.2 to 141.9/75.6 mmHg, respectively, P<0.001) and TG levels (from 159.2 to 108.0 mg/dl and from 2 08.7 to 153.1 mg/dl, respectively, P<0.001). However, a favorable reduction in hemostasis parameters (platelet aggregation on extracellular matrix and (alpha(2)-antiplasmin) was only seen among the nondiabetic patients (from 12.1+/-4.9 to 4.2+/-3.2%, P<0.001). This difference may stem from a less ef ficient exchange between n-3 and n-6 PUFA in serum phospholipid of the OHDDM patients. Overall, this 13-day fasting/refeeding method developed by us has proven to cause the rapid exchange of arachidonic acid for eicosapentae noic acid. It appears to be an effective regimen for the reduction of cardi ovascular risk factors (BP, TG and hemostatic variables) in OHD-DM patients and to a lesser extent in OHD+DM patients.