Omega-3 fatty acids improve blood pressure control and preserve renal function in hypertensive heart transplant recipients

Background Hypertension and cyclosporine-induced nephrotoxicity are common complications in heart transplant recipients. Omega-3 fatty acids may preve nt blood pressure rise early, but have not been studied long-term after hea rt transplantation. Methods and Results Forty-five clinically stable hypertensive heart transpl ant recipients were studied 1-12 years after transplantation and randomized in a double-blind fashion to receive either 3.4 g of omega-3 fatty acids d aily or placebo for 1 year. Ambulatory 24 h blood pressure monitoring and h aemodynamic studies were performed before randomization and at the end of t he study. Systolic blood pressure increased by 8 +/- 3 mmHg (P<0.01) in the placebo group, with a non-significant increase in diastolic blood pressure of 3 +/- 2 mmHg (P=0.10), accompanied by a 14% increase in systemic vascul ar resistance (P<0.05). In contrast, no change in blood pressure or systemi c 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 an tihypertensive effect was related to an increase in serum eicosapentaenoic and docosahexaenoic acid. Conclusion Treatment with omega-3 fatty acids may reduce the long-term cont inuous rise in blood pressure after heart transplantation and may offer a d irect or indirect renoprotective effect, making these fatty acids a potenti ally attractive treatment for post-transplant hypertension. (Eur Heart J 20 01; 22: 428-136, doi:10, 1053/euhj.2000.2369) (C) 2001 The European Society of Cardiology.