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      Exploratory serum fatty acid patterns associated with blood pressure in community-dwelling middle-aged and elderly Chinese

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          Abstract

          Background

          Epidemiological studies have assessed relationships between circulating levels of fatty acid (FA) and blood pressure (BP), and their results remain controversial. Nevertheless, data are sparse on serum FA as biomarker and BP in China. The aim of the study was to investigate the association between serum FA and BP in Chinese populations.

          Methods

          We conducted a cross-sectional study nested within a community-based cohort of 2447 Chinese participants aged 35–79 years who completed a baseline assessment between October 2012 and April 2013. Baseline assessment included the collection of fasting blood samples, anthropometric measurements and a personal interview using a validated questionnaire. Serum FA was determined by gas-liquid chromatography. Exploratory factor analyses were employed to identify FA-factor as a reflection of serum FA pattern. A multiple regression model was conducted to estimate adjusted mean of BP with 95 % confidence interval (CI) by tertile groups of the generated FA-factor scores.

          Results

          Hypertensive patients have significantly higher serum 14:0, 16:0, 16:1n-7, 18:3n-6, 20:3n-6 and Δ 6-desaturase index (18:3n-6/18:2n-6) as well as lower 18:2n-6, 22:6n-3 and Δ 5-desaturase index (20:4n-6/20:3n-6) compared with normotensive participants. Factor 1 (low linoleic acid/high saturated FA pattern: 14:0, 16:0, 16:1n-7, 18:2n-6, 18:3n-6, 20:3n-6) and Factor 2 (n-3 PUFA pattern: 20:5n-3, 22:5n-3, 22:6n-3, 18:1n-9) were identified as indicators of the serum FA pattern. After adjustment for age, gender, body mass index, hypertension treatment, smoking, alcohol intake, education, profession, exercise habit, salt intake, family history of hypertension, heart rate, blood lipids and fasting blood-glucose levels, per a standard deviation (SD) increment of Factor 1 scores was associated with an increment of 2.44 (95 % CI: 1.73, 3.15) mm Hg for systolic BP, whereas per a SD increment of Factor 2 scores was associated with a reduction of 1.40 (95 % CI: 0.80, 2.04) mm Hg for diastolic BP.

          Conclusions

          The serum FA pattern characterized by low proportions of 14:0, 16:0, 16:1n-7 and 18:3n-6 as well as high 18:2n-6 and 22:6n-3 was beneficially associated with BP levels in this Chinese population. This evidence well supports the current dietary recommendations in the communities to replace saturated fat with polyunsaturated fat.

          Electronic supplementary material

          The online version of this article (doi:10.1186/s12944-016-0226-3) contains supplementary material, which is available to authorized users.

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          Most cited references46

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          Long-Chain Omega-3 Fatty Acids Eicosapentaenoic Acid and Docosahexaenoic Acid and Blood Pressure: A Meta-Analysis of Randomized Controlled Trials

          BACKGROUND Although a large body of literature has been devoted to examining the relationship between eicosapentaenoic and docosahexaenoic acids (EPA+DHA) and blood pressure, past systematic reviews have been hampered by narrow inclusion criteria and a limited scope of analytical subgroups. In addition, no meta-analysis to date has captured the substantial volume of randomized controlled trials (RCTs) published in the past 2 years. The objective of this meta-analysis was to examine the effect of EPA+DHA, without upper dose limits and including food sources, on blood pressure in RCTs. METHODS Random-effects meta-analyses were used to generate weighted group mean differences and 95% confidence intervals (CIs) between the EPA+DHA group and the placebo group. Analyses were conducted for subgroups defined by key subject or study characteristics. RESULTS Seventy RCTs were included. Compared with placebo, EPA+DHA provision reduced systolic blood pressure (−1.52mm Hg; 95% confidence interval (CI) = −2.25 to −0.79) and diastolic blood pressure ( − 0.99mm Hg; 95% CI = − 1.54 to − 0.44) in the meta-analyses of all studies combined. The strongest effects of EPA+DHA were observed among untreated hypertensive subjects (systolic blood pressure = − 4.51mm Hg, 95% CI = − 6.12 to − 2.83; diastolic blood pressure = − 3.05mm Hg, 95% CI = − 4.35 to − 1.74), although blood pressure also was lowered among normotensive subjects (systolic blood pressure = − 1.25mm Hg, 95% CI = − 2.05 to − 0.46; diastolic blood pressure = − 0.62mm Hg, 95% CI = − 1.22 to − 0.02). CONCLUSIONS Overall, available evidence from RCTs indicates that provision of EPA+DHA reduces systolic blood pressure, while provision of ≥2 grams reduces diastolic blood pressure.
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            Does fish oil lower blood pressure? A meta-analysis of controlled trials.

            In a meta-analysis of 31 placebo-controlled trials on 1356 subjects, we examined the effect of omega-3 fatty acids in fish oil on blood pressure by grouping studies that were similar in fish oil dose, length of treatment, health of the subjects, or study design. The mean reduction in blood pressure caused by fish oil for the 31 studies was -3.0/-1.5 mm Hg (95% confidence intervals: systolic blood pressure: -4.5, -1.5; diastolic blood pressure: -2.2, -0.8). There was a statistically significant dose-response effect when studies were grouped by omega-3 fatty acid dose: -1.3/-0.7 mm Hg at doses < or = 3 g/d, -2.9/-1.6 mm Hg at 3.3 to 7 g/d, and -8.1/-5.8 mm Hg at 15 g/d. Both eicosapentaenoic acid and docosahexaenoic acid were significantly related to blood pressure response. There was no effect on blood pressure in eight studies of "healthy" persons (mean reduction, -0.4/-0.7 mm Hg) at an overall mean dose of 4.2 g omega-3 fatty acids/d. By contrast, there was a significant effect of -3.4/-2.0 mm Hg in the group of hypertensive studies with a mean fish oil dose of 5.6 g/d and on systolic blood pressure only in six studies of hypercholesterolemic patients (-4.4/-1.1 mm Hg) with a mean dose of 4.0 g/d. A nonsignificant decrease in blood pressure was observed in four studies of patients with atherosclerotic cardiovascular disease (-6.3/-2.9 mm Hg). Variations in the length of treatment (from 3 to 24 weeks), type of placebo, and study design (crossover or parallel groups) did not appear to account for inconsistent findings among studies. There is a dose-response effect of fish oil on blood pressure of -0.66/-0.35 mm Hg/g omega-3 fatty acids. The hypotensive effect may be strongest in hypertensive subjects and those with clinical atherosclerotic disease or hypercholesterolemia.
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              Effect of fish oil on heart rate in humans: a meta-analysis of randomized controlled trials.

              The effect of fish oil on heart rate (HR), a major risk factor for sudden death, is not well established. We calculated this effect in a meta-analysis of randomized, double-blind, placebo-controlled trials in humans. Randomized trials of fish oil that evaluated HR were identified through MEDLINE (1966 through January 2005), hand-searching of references, and contact with investigators for unpublished results. Two investigators independently extracted trial data. A pooled estimate was calculated from random-effects meta-analysis. Predefined stratified meta-analyses and meta-regression were used to explore potential heterogeneity. Of 197 identified articles, 30 met inclusion criteria. Evidence for publication bias was not present. In the overall pooled estimate, fish oil decreased HR by 1.6 bpm (95% CI, 0.6 to 2.5; P=0.002) compared with placebo. Between-trial heterogeneity was evident (Q test, P or =69 bpm (median) but had little effect (0.04-bpm reduction; P=0.56) in trials with baseline HR or =12 weeks but had less effect (0.7-bpm reduction; P=0.27) in trials with duration 0.25 for each). In randomized controlled trials in humans, fish oil reduces HR, particularly in those with higher baseline HR or longer treatment duration. These findings provide firm evidence that fish oil consumption directly or indirectly affects cardiac electrophysiology in humans. Potential mechanisms such as effects on the sinus node, ventricular efficiency, or autonomic function deserve further investigation.
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                Author and article information

                Contributors
                ybzju@zju.edu.cn
                +86-571-88982024 , duoli@zju.edu.cn
                +86-571-81595291 , yuweipost@163.com
                Journal
                Lipids Health Dis
                Lipids Health Dis
                Lipids in Health and Disease
                BioMed Central (London )
                1476-511X
                18 March 2016
                18 March 2016
                2016
                : 15
                : 58
                Affiliations
                [ ]Department of Food Science and Nutrition, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058 China
                [ ]The Province Center for Cardio-Cerebral-Vascular Disease, Zhejiang Hospital, 12 Linyin Road, Hangzhou, 310013 China
                Article
                226
                10.1186/s12944-016-0226-3
                4797152
                26993260
                339da453-b9de-4a4f-96f7-6c64dc522058
                © Yang et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 7 November 2015
                : 9 March 2016
                Funding
                Funded by: the National Basic Research Program of China
                Award ID: 2015CB553604
                Award Recipient :
                Funded by: the National Natural Science Foundation of China
                Award ID: 81273054
                Award Recipient :
                Funded by: the PhD Programs Foundation of Ministry of Education of China
                Award ID: 20120101110107
                Award Recipient :
                Funded by: the Ministry of Science and Technology of China
                Award ID: 2014BAI08B01
                Award Recipient :
                Funded by: the Medical research projects in Zhejiang province
                Award ID: 2010KJY010
                Award Recipient :
                Categories
                Research
                Custom metadata
                © The Author(s) 2016

                Biochemistry
                blood pressure,fatty acid,factor analysis,hypertension
                Biochemistry
                blood pressure, fatty acid, factor analysis, hypertension

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