Cyclosporine-induced hypertension. Efficacy of omega-3 fatty acids in patients after cardiac transplantation

Abstract

Background: Cyclosporine-induced hypertension may be related to vasoconstriction of the afferent arterioles in the glomeruli caused by changes in the prostaglandin profile. omega-3 Fatty acids have demonstrated vasodilatory properties related to a favorable effect in the prostaglandin profile. The purpose of this study was to evaluate the antihypertensive effects of oral supplementation with omega-3 fatty acids in cyclosporine-treated cardiac transplant recipients.

Methods and results: The study consisted of 20 orthotopic cardiac transplant recipients with hypertension who were prospectively randomized in a double-blind fashion to receive either omega-6 fatty acids (placebo group, n = 10) or omega-3 fatty acids (treatment group, n = 10). Blood pressure, systemic hemodynamics, two-dimensional guided M-mode and Doppler echocardiography, and laboratory values (serum creatinine, lipid profile) were recorded at baseline and at 12 weeks. The treatment group demonstrated a significant reduction in mean arterial pressure (120 +/- 7 versus 102 +/- 7 mm Hg; P = .0001) associated with a decrease in systemic vascular resistance (2107 +/- 45 versus 1426 +/- 60 dynes.sec.cm-5; P = .0001). No changes in indexes of left ventricular structure and function occurred, except for a modest decrease in deceleration time (211 +/- 10 versus 182 +/- 12 milliseconds; P = .05), an index of left ventricular diastolic function.

Conclusions: omega-3 Fatty acids (3 g/d) reduce blood pressure by decreasing systemic vascular resistance and, therefore, can be used as an adjuvant for the treatment of hypertension in cyclosporine-treated cardiac transplant recipients. Their vasodilatory effect may be related to a beneficial change in the prostaglandin profile.