The application of the omega-3 Fatty acid in the cardiology practice

Interest in the omega-3 Fatty acid is fairly recent, showing a sharp growth in the beginning of the 1980s. At this time Danish scientists J. Dyerberg and H. Bang established that the extremely low level of cardiovascular diseases such as atherosclerosis, the ischemic heart disease, and hypertonic disease in the inhabitants of Greenland is explained, most likely, by the consumption of a large quantity of sea products with a high content of omega-3 Fatty acid.

Scientists demonstrated that the inhabitants of Greenland, in comparison with the Danes, had a higher concentration of eicosapentaenoic and docosahexaenoic acid in the blood, while at the same time having a low content of linoleic and arachidonic acid. This data was confirmed by the results of the epidemiological inspections of the population of coastal areas of Japan, Netherlands and other countries.

Scientists later revealed that omega-3 fatty acid not only produces hypoglycemic (bloodsugar-lowering) effect, but also renders the hypo-coagulation (blood thinning), antipyretic and immuno-modulating action. Motivations for the therapeutic application of omega-3 fatty acid are partially connected with its influence on the eicosanoids system.

Omega-3 fatty acid is the competitory antagonist of arachidonic acid. Arachidonic acid is the basic substratum in the synthesis of prostaglandins, thromboxanes and leucotrines in the organism. Arachidonic acid is the predecessor for prostaglandins-2 class and leucotrines-4 class. At the same time omega-3 fatty acid is a substratum for the synthesis of prostaglandins 3 and leucotrines 5 classes. When Eicosapentaenoic and Docosahexaenoic acid enter the organism via food (in the organism these acids are not synthesized) they partially replace omega-6 fatty acid in the membranes of thrombocytes, erythrocytes, neutrophils, monocytes, the liver and other cells.

Competition between the arachidonic acid and Omega-3 fatty acid at the Cyclooxygenase and Lipoxygenase level is manifested by the modification of prostaglandins and leucotrines spectrum. This results in a decrease in the production of the prostaglandin metabolites (PGE2). This also leads to the reduced levels of thromboxanes which are powerful vasoconstrictors (substances causing vascular spasms).

While it is true that the action mechanism of omega-3 fatty acid on other components of the blood coagulation system cannot as of yet be exhaustively explained, significant facts exist; for example, omega-3 fatty acid’s ability to decrease the concentration of fibrinogen which leads to the activation of blood clot formation.

The cholesterol-lowering action of fish oil involves the suppression of the synthesis of very low density lipoproteins (VLDL); it also improves their clearance and increases the excretion of bile. Many uncomplimentary words in the address of arachidonic acid have been heard recently. Apparently, it is necessary to put up several arguments in defense of this substance. Arachidonic acid is irreplaceable, it is necessary for the functioning of our organism. Arachidonic acid’s metabolites fulfill important regulatory functions, since normal health conditions require maintenance of muscle tone, the retention of the vessel integrity, and averting hemophilia resulting from injuries.

When the organism is in a sickened state, this unspecific compensating adaptive reaction can be become pathological. The overproduction of blood vessels’ constrictive substances activate of thromboagregation and may cause clot formation. Thus sick people are in need of necessary eicosapentaenoic acid metabolites, which may help to avoid blood vessel spasms and clot formation.

The application of preparations which contain Eicosapentaenoic and Docosahexaenoic acids for the diseases pertaining to the cardiovascular system is based on the antiatherosclerotic and hypo-coagulation effects of omega-3 fatty acid.

The results of numerous experimental and clinical experiments attest to the fact that omega-3 fatty acid substantially decreases the aggregative ability of blood. In 1999, the results of the multi-center studies were published. These studies were carried out by GISSI, Prevention Coordinating Centre, which highlighted the future of this prospect and its efforts to move in the direction of cardiology. The randomized double blind study in the effectiveness of omega-3 fatty acid was done with 11,324 patients, who suffered myocardial infarction. The patients received 1g of omega-3 fatty acid in a 24 hour period for a period of 3 to 5 years. The results showed that even with the use of contemporary treatment that includes aspirin, ACE-inhibitors, Beta-blockers and statins, inclusion of omega-3 fatty acid reliably decreases the mortality rates from coronary artery disease. It also decreased the number of cases of repeated myocardial infarction.