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

Abstract

Background: Hypertension and cyclosporine-induced nephrotoxicity are common complications in heart transplant recipients. Omega-3 fatty acids may prevent blood pressure rise early, but have not been studied long-term after heart transplantation. Methods and Results: Forty-five clinically stable hypertensive heart transplant 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 daily or placebo for 1 year. Ambulatory 24 h blood pressure monitoring and haemodynamic studies were performed before randomization and at the end of the 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 vascular resistance (P<0·05). In contrast, no change in blood pressure or systemic 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 antihypertensive effect was related to an increase in serum eicosapentaenoic and docosahexaenoic acid. Conclusion: Treatment with omega-3 fatty acids may reduce the long-term continuous rise in blood pressure after heart transplantation and may offer a direct or indirect renoprotective effect, making these fatty acids a potentially attractive treatment for post-transplant hypertension. © 2001 The European Society of Cardiology.