Omega 3 Reduction In Arrhythmia Fatal Heart Attack Risk In Diabetic Patients

Small increase in daily omega-3 results in large reduction in arrhythmia-related events and fatal heart attack risk in diabetic patients

Small increase in daily omega-3 results in large reduction in arrhythmia-related events and fatal heart attack risk in diabetic patients

Friday, December 2, 2011. An analysis of a clinical trial published in the December, 2011 issue of the journal Diabetes Care reveals a reduction in the risk of ventricular arrhythmia-related events and fatal myocardial infarction (MI) among diabetics who received low doses of the omega-3 fatty acids eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and alpha-linolenic acid (ALA). Ventricular arrhythmias are the main cause of cardiac arrest and sudden death, and frequently necessitate defibrillator implantation.

The subjects included men and women with a history of heart attack within the decade prior to enrollment in the Alpha Omega Trial, which sought to determine the effects of EPA, DHA and ALA on fatal coronary heart disease and ventricular-arrhythmia related events. While a benefit for omega-3 was not confirmed in this population, the current analysis sought to determine the effects in a subgroup of 1,014 diabetic patients, aged 60 to 80 years.

Participants were randomized to receive margarine that provided 223 milligrams EPA and 149 DHA per day, 1.9 grams ALA per day, both EPA/DHA and ALA, or no additional omega-3 fatty acids for 40 months. Compliance was assessed by analysis of plasma fatty acids at the beginning of the study, at 20 months, and at the trial's conclusion. Participants were followed for clinical events, including fatal coronary heart disease (defined as mortality from heart attack), and fatal and nonfatal ventricular arrhythmia-related events.

Twenty-nine patients developed ventricular arrhythmia-related events and 27 had fatal heart attacks over follow-up. The Dutch research team observed an 84 percent lower risk of ventricular arrhythmia-related events and a 72 percent lower risk of combined ventricular arrhythmia-related events and fatal coronary events in participants who received both EPA/DHA and ALA compared to those who consumed unenhanced margarine. The authors remark that EPA and DHA may act as binding sites for peroxisome proliferator-activated receptor gamma, which plays an important role in insulin sensitivity regulation. Other research suggests that fish oil, a popular source of omega-3, may increase the expression of glucose uptake genes, thereby lowering glucose levels. In addition, the omega-3 fatty acids have anti-inflammatory properties that may help reverse insulin resistance according to the results of laboratory studies.

"Low doses of omega-3 fatty acids reduced the risk of ventricular arrhythmia–related events in post-MI patients who also have diabetes," the authors conclude. "The results of more trials on the effect of different omega-3 fatty acids are needed before definitive conclusions can be drawn on their role in the etiology of ventricular arrhythmias and fatal coronary heart disease."

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Seven could give you ten

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A presentation on October 23, 2011 at the Canadian Cardiovascular Congress held in Vancouver recommends the adoption of seven simple measures that could add ten years or more to the average life span.

Dr Clyde Yancy of Northwestern University's Feinberg School of Medicine predicts that "Achieving these seven simple lifestyle factors gives people a 90 per cent chance of living to the age of 90 or 100, free of not only heart disease and stroke but from a number of other chronic illnesses including cancer. By following these steps, we can compress life-threatening disease into the final stages of life and maintain quality of life for the longest possible time."

The steps recommended for Canadians and others include increasing physical activity, knowing and controlling cholesterol levels, following a healthy diet, knowing and controlling blood pressure, achieving and maintaining a healthy weight, managing diabetes and not smoking. These factors, while commonly acknowledged to help reduce the risk of heart attack and stroke, are practiced regularly by only less than 10 percent of the population. "We know how to prevent heart disease and stroke – we now need to build the tools to empower our citizens to manage their risk and prevent heart disease," Dr Yancy noted.

Heart and Stroke Foundation of Canada president Bobbe Wood agreed that "Healthy living is key to preventing heart disease and stroke. The Foundation is committed to raising awareness about heart health and to promoting public policies that facilitate healthy lifestyles and communities."

"The opportunity for prevention is not an unrealistic expectation," Dr Yancy affirmed. "Over the past 40 years the rates of heart disease and stroke have steadily declined."

However, given the rising incidence of obesity and diabetes, he emphasized that "We need to act now."

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