Section Review—Cardiovascular & Renal: n-3 Fatty Acids as Adjuvants to Conventional Therapy in Patients with Coronary Artery Disease

References

• LEAF A, WEBER PC: Cardiovascular effects of n-3 fatty acids. New Engl. J. Med. (1988) 318:549-557. A classic early overview of the beneficial effct of n-3 PUFA in CAD.
   Google Scholar
• SPECTOR AA, YOREK MA: Membrane lipid compositionand cellular function. J. Lipid Res. (1985) 26:1015–1035.
   PubMed Web of Science ®Google Scholar
• LANDS WEM: Biosynthesis of prostaglandins. Ann. Rev.Nutr. (1991) 11:41–60.
   PubMed Web of Science ®Google Scholar
• VON SCHACKY C, WEBER PC: Metabolism and effects onplatelet function of the purified eicosapentaenoic and docosahexaenoic add in humans. J. Chn. Invest. (1985) 76:2446–2450.
   PubMed Web of Science ®Google Scholar
• FISCHER S, VISCHER A, PREAC-MURSIC V, ET AL.: Dietary docosahexaenoic acid is retroconverted in man to ei-cosapentaenoic add which can be quickly transformed to prostaglandin 13. Prostaglandins (1987) 34:367–375.
   Google Scholar
• HIRAI A, TERANO T, TAMURA Y, ET AL.: Eicosapentaenoic acid and adult diseases in Japan: Epidemiological and clinical aspects. J. Intern. Med. (1989) 225\(Suppl. 1):69–75.
   Google Scholar
• KROMANN N, GREEN A: Epidemiological studies in Uper-navik district, Greenland. Acta Med. Scand. (1980) 208:401–406.
   PubMed Web of Science ®Google Scholar
• BJERREGAARD P, DYERBERG J: Mortality from ischaemicheart disease and cerebrovascular disease in Green-land. Int. J. Epidemiol. (1988) 17:514–519.
   PubMed Web of Science ®Google Scholar
• INGEMAN-NIELSEN MW: Arteriosklerose hos gronlxn-dere. Ugeskr. Laeger (1990) 152:2641–2643.
   PubMedGoogle Scholar
• HANSEN JPH, HANCKE S, MOLLER-PETERSEN J: Atherosclerosis in native Greenlanders. An ultrasonog-raphic investigation. Arctic Med. Res. (1990) 49:151–156.
   PubMedGoogle Scholar
• NEWMAN III WP, PROPST MT, MIDDAUGH JP: Atherosclerosis in Alaska natives and non-natives. Lan-cet (1993) 341:1056-1057. A recent study showing less atherosclerosis in Alaskan Eskimos compared to non-native Alaskans.
   Google Scholar
• KAGAWA Y, NISHIZAWA M, SUZUKI M, ET AL.: Eicos-apolyertoic acids of serum lipids of Japanese Islanders with low incidence of cardiovascular diseases. J. Nutr. Sci. Vitaminol. (1982) 28:441–453.
   Google Scholar
• KROMHOUT D, BOSSCHIETER EB, COULANDER CDL: TheInverse relation between fish consumption and 20-year mortality from coronary heart disease. New Engl.J. Med. (1985) 312:1205-1209. This study shows a reduced incidence of CAD after intake of very low amounts of fish in a Western population.
   Google Scholar
• SHEKELLE RB, MISSELL LV, PAUL 0, ETAL.: Fish consump-tion and mortality from coronary heart disease. New Engl. J. Med. (1985) 313:820.
   Google Scholar
• NORELL SE, AHLBOM A, FEYCHTING M, ET AL.: Fish consumption and mortality from heart disease. BMJ (1986) 293:426.
   Google Scholar
• GRAMENZI A, GENTILE A, FASOLI M, ET AL.: Assodationbetween certain foods and risk of acute myocardial Infarction in women. BMJ (1990) 300:771–773.
   Google Scholar
• DOLECEK TA, GRANDITS G: Dietary polyunsaturated fatty adds and mortality in the multiple risk factor Intervention trial (MRFIT). World Rev. Nutr. Diet. (1991) 66:205–216.
   PubMedGoogle Scholar
• FESKENS EJM, BOWLES CH, KROMHOUT D: Associationbetween fish intake and coronary heart disease mortal-ity. Diabetes Care (1993) 16:1029–1034.
   PubMedGoogle Scholar
• CROMBIE IK, MCLOONE P, SMITH WCS, ET AL.: Interna-tional differences in coronary heart disease mortality and consumption of fish and other foodstuffs. Eur. Heart J. (1987) 8:560–563.
   Google Scholar
• VOLLSET SE, HEUCH I, BJELKE E: Fish consumption and coronary heart disease. New Engl, J. Med. (1985) 313:820–821.
   PubMedGoogle Scholar
• CURB JD, REED DM: Fish consumption and coronaryheart disease. New Engl. J. Med. (1985) 313:821.
   Web of Science ®Google Scholar
• LAPIDUS L, ANDERSSON H, BENGTSSON C, ET AL.: Dietary habits in relation to incidence of cardiovascular disease and death in women: A 12-year follow-up of partid-pants in the population study of women in Gothenburg, Sweden. Am. J. Gun. Nutr. (1986) 44:444–448.
   Google Scholar
• SIMONSEN T, VÁRTUN A, LYNGMO V, ET AL.: Coronary Heart Disease, Serum Lipids, Platelets and Dietary Fish in Two Communities in Northern Norway. Acta Med. Scand. (1987) 222:237–245.
   PubMed Web of Science ®Google Scholar
• HUNTER DJ, KAZDA I, CHOCKAUNGAM A, ET AL.: FishConsumption and Cardiovascular Mortality in Canada: An Inter-Regional Comparison. Am. J. Prev. Med. (1988) 4:5–10.
   Google Scholar
• MORRIS MC, MANSON JE, ROSNER B, ET AL.: A prospectivestudy of fish consumption on cardiovascular disease [Abstract]. Circulation (1992) 86(Suppl. I):1–463.
   Google Scholar
• AURSNES I, DORUM H-P, SMITH P, ET AL.: Low and highrisk coronary patients discriminated by blood platelet fatty add composition. Scand. J. Clin. Lab. Invest. (1986) 46:115–120.
   Google Scholar
• WOOD DA, BUTLERS, MACINTYRE C, ET AL.: Linoleic andeicosapentaenoic acids in adipose tissue and platelets and risk of coronary heart disease. Lancet (1987) i:177–183.
   Google Scholar
• SEIDELIN KN, MYRUP B, FISCHER-HANSEN B: n-3 fatty adds in adipose tissue and coronary artery disease are inversely related. Am. J. Clin. Nutr. (1992) 55:1117–1119.
   PubMed Web of Science ®Google Scholar
• LUOSTARINEN R, BOBERG M, SALDEEN T: Fatty add composition in total phospholipids of human coronary arteries in sudden cardiac death. Atherosclerosis (1993) 99:187–193.
   PubMed Web of Science ®Google Scholar
• BANG HO, DYERBERG J, NIELSEN AB: Plasma lipid andlipoprotein pattern in Greenlandic West coast Eskimos. Lancet (1971) 11143–1146.
   Google Scholar
• •• The first study showing a beneficial lipid pattern in Greenland Eskimos, initiating the interest in n-3 PUFA as a dietary tool to reduce CAD.
   Google Scholar
• BANG HO, DYERBERG J, SINCLAIR HM: The compositionof Eskimo food in North-Western Greenland. Am.J. Clin. Nutr. (1980) 33:2657–2661.
   PubMed Web of Science ®Google Scholar
• DYERBERG J, BANG HO, STOFFERSEN E, ET AL.: Eicosap-entaenoic acid and prevention of thrombosis and atherosclerosis? Lancet (1978) II:117-119. A major study suggesting that n-3 PUFA may protect against throm-bosis.
   Google Scholar
• DYERBERG J, BANG HO. Haemostatic function and plate-let polyunsaturated fatty acids in Eskimos. Lancet (1979) 11:433-435. This study shows that Greenland Eskimos have a strongly attenuated platelet reactivity.
   Google Scholar
• GERDES LU, SCHMIDT EB, KLAUSEN IC, ET AL.: Plasma Concentration Levels of Apolipoprotein A-I and Lipo-protein(a) in Greenland Inuit (Eskimos). J. Intern. Med. (1992) 231:623–625.
   Google Scholar
• KLAUSEN IC, GERDES LU, SCHMIDT EB, ET AL.: Differ-ences in apolipoprotein(a) polymorphism in West Greenland Eskimos and caucasian Danes. Hum. Genet. (1992) 89:384–388.
   Google Scholar
• DE KNUFF P, JOHANSEN LG, ROSSENEU M, ET AL.: Lipo-protein profile of a Greenland Inuit population. Arterio-sclerosis Thromb. (1992) 12:1371–1379.
   Google Scholar
• HARVALD B: Genetic epidemiology of Greenland. Clin.Genet. (1989) 36:364–367.
   PubMed Web of Science ®Google Scholar
• JORGENSEN KA, NIELSEN AH, DYERBERG J: Hemostaticfactors and renin in Greenland Eskimos on a high eicosapentaenoic acid intake. Acta Med. Scand. (1986) 219:473–479.
   PubMed Web of Science ®Google Scholar
• FISCHER S, WEBER PC, DYERBERG J: The prostacyclin/ thromboxane balance is favourably shifted in Green-land Eskimos. Prostaglandins (1986) 32:235–241.
   PubMed Web of Science ®Google Scholar
• SCHMIDT EB, SORENSEN PJ, ERNST E, ET AL.: Studies on coagulation and fibrinolysis in Greenland Eskimos. Thromb. Res. (1989) 56:553–558.
   Google Scholar
• PARKS JS, RUDEL LL: Effect of fish oil on atherosclerosisand lipoprotein metabolism. Atherosclerosis (1990) 84:83–94.
   PubMed Web of Science ®Google Scholar
• ZHU B-Q, PARMLEY WW: Modification of experimental and clinical atherosclerosis by dietary fish oil. Am. Heart J.(1990) 119:168–178.
   PubMed Web of Science ®Google Scholar
• SASSEN LMA, LAMERS JMJ, SLUITER W, ET AL.: Develop-ment and regression of atherosclerosis in pigs. Arterios-cler. Thromb. (1993) 13:651-660. An excellent review on the effect of n-3 PUFA on experimental atherosclerosis.
   Google Scholar
• KIM DN, SCHMEE J, LEE CS, ET AL.: Comparison of effectsof fish oil and corn oil supplements on hyperlipidemic diet induced atherogenesis in swine. Atherosclerosis (1991) 89:191–201.
   Google Scholar
• SASSEN LMA, HARTOG JM, LAMERS JMJ, ET AL.: Mackereloil and atherosclerosis in pigs. Eur. Heart J. (1989) 10:838–846.
   Web of Science ®Google Scholar
• WEINER BH, OCKENE IS, LEVINE PH, ET AL.: Inhibition of atherosclerosis by cod-liver oil in a hyperlipidemicswine modeL New Engl. J. Med. (1986) 315:841-846. An early study showing pronounced anti-atherosclerotic effects of n-3 PUFA in pigs.
   Google Scholar
• DAVIS HR, BRIDENSTINE RT, VESSELINOVITCH D, ET AL.: Fish oil inhibits development of atherosclerosis in rhesus monkeys. Arteriosclerosis (1987) 7:441–449.
   Google Scholar
• THIERY J, SEIDEL D: Fish oil feeding results in an enhancement of cholesterol-induced atherosclerosis in rabbits. Atherosclerosis (1987) 63:53–56.
   PubMed Web of Science ®Google Scholar
• ROGERS KA, ADELSTEIN R. MAX EP: A fish oil enhances cholesterol-induced intimal foam cell formation in rab-bits. Am. J. Pathol. (1990) 137:945–951.
   Google Scholar
• RICEVUTI G, MAZZONE A, PASOTTI D, ET AL.: Role of granulocytes in endothelial injury in coronary heart disease in humans. Atherosclerosis (1991) 91:1–14.
   Google Scholar
• CULP BR, LANDS WEM, LUCCHESI BR, ET AL.: The effectof dietary supplementation of fish oil on experimental myocardial infarction. Prostaglandins (1980) 20:1021–1031.
   Google Scholar
• HOCK CE, HOLAHAN MA, REIBEL DK: Effect of dietary fish oil on myocardial phospholipids and myocardial ischemic damage. Am. J. Physiol. (1987) 252:H554–560.
   PubMed Web of Science ®Google Scholar
• HOCK CE, BECK ID, BODINE RC, ET AL.: Influence of dietary n-3 fatty adds on myocardial ischesnia and reperfusion. Am. J. Physiol. (1990) 259:H1518–1526.
   Google Scholar
• °TSUJI S, SHIBATA N, HIROTA H, ET AL.: Highly purified eicosapentaenoic acid attenuates tissue damage in ex-perimental myocardial infarction. Jpn. Circ. J. (1993) 57:335–343.
   Google Scholar
• OSKARSSON HI, GOODWIN J, GUNNAR RM, ET AL.: Die-• tary fish oil supplementation reduces myocardial in-farct size in a canine model of ischemia and reperfusion. J. Am. Coll. Cardiol. (1993) 21:1280-1285. This study shows that n-3 PUFA may limit infarct size.
   Google Scholar
• HORNSTRA G: The significance of fish and and fish-oil, enriched food for prevention and therapy of cardiovas-cular disease. In: The role of fats in human nutrition. Vergroesen A, Crawford M (Eds.). Academic Press (1989):152–235. An excellent comprehensive review on the effects of n-3 PUFA in CAD.
   Google Scholar
• LANDYMORE RW, MACAULEY M, SHERIDAN W, ET AL.: Cumulative experience with eicosapentaenoic add and other platelet inhibitors for the prevention of intimal hyperplasia in autologous vein grafts. In: Proceedings of the AOCS short course on polyunsaturated fatty acids and eicosanoids. Lands WEM (Ed.). Biloxi (1987):342–345.
   Google Scholar
• SARRIS GE, MITCHELL RS, BILLINGHAM ME, ET AL.: Inhi-bition of accelerated cardiac allograft arteriosclerosis by fish oil. J. Thorac. Cardiovasc. Surg. (1989) 97:841–855.
   Google Scholar
• O'HARA M, ESATO K, HARADA M, ET AL.: Ekosapen-taenoic acid suppresses intimal hyperplasia after ex-panded polytetrafluorethylene grafting in rabbits fed a high cholesterol diet. j Vase. Sutg. (1991) 13:480–486.
   Google Scholar
• HARKER LA, KELLY AB, HANSON SR, ET AL.: Interruption of vascular thrombus formation and vascular lesion formation by dietary n-3 fatty acids in fish oil in non- human primates. Circulation (1993) 87:1017-1029. A recent extensive study showing anti-thrombotic effects of n-3 PUPA in non-human primates.
   Google Scholar
• LAM JYT, BADIMON JJ, ELLEFSON RD, ET AL.: Cod liver oil alters platelet-arterial wall response to injury in pigs. Circ. Res. (1992) 71:769–775.
   Google Scholar
• This study shows that n-3 PUFA may beneficially alter the platelet-vessel wall interaction.
   Google Scholar
• GOTTO JR AM, LAROSA JC, HUNNINGHAKE D, ET AL.: The cholesterol facts. Circulation (1990) 81:1721–1732.
   Google Scholar
• AUSTIN MA: Plasma triglycerides and coronary heart disease. Arteriosclerosis (1991) 11:2–14.
   Google Scholar
• MEADE TW, MELLOWS S, BROZOVIC M, ET AL.: Haemo-static function and ischaemic heart disease: Principal results of the Nortwick Park heart study. Lancet (1986) 11:533–537.
   Google Scholar
• ERNST E: The role of fibrinogen as a cardiovascular risk factor. Atherosclerosis (1993) 100:1–12.
   PubMed Web of Science ®Google Scholar
• WIMAN B, HAMSTEN A: Impaired fibrinolysis and risk of thromboembolism. Prog. Cardiovasc. Dis. (1991) 34:179–192.
   PubMed Web of Science ®Google Scholar
• JESPERSEN J, MLTNKVAD S, GRAM JB: The fibrinolysis and coagulation systems in ischaemic heart disease. Dan. Med. Bull, (1993) 40:495–502.
   PubMed Web of Science ®Google Scholar
• FUSTER V, BADIMON L, BADIMON JJ, ET AL.: The patho-genesis of coronary artery disease and the acute coro-nary syndromes. New Engl. J. Med. (1992) 326:242-250 & 310–318. An excellent overview of the pathogenesis of CAD.
   Google Scholar
• ROSS R: The pathogenesis of atherosclerosis: a perspec- five for the 1990s. Nature (1993) 362:801-809. An excellent paper on atherogenesis focusing on the role of growth factors and immunological mechanisms.
   Google Scholar
• HARRIS WS: Fish oils and plasma lipid and lipoprotein metabolism in humans: A critical review. J. Lipid Res. (1989) 30:785-807. Excellent review on the effects of n-3 PUFA on lipids and lipopro-teins.
   Google Scholar
• SCHMIDT EB, KRISTENSEN SD, DE CATERINA R, ET AL,: •The effects of n-3 fatty adds on plasma lipids andlipoproteins and other cardiovascular risk factors in patients with hyperlipidemia. Atherosclerosis (1993) 103:107-121. A recent review on the effects of n-3 PUFA in patients with hyperlipidaemia.
   Google Scholar
• SCHMIDT EB, VARMING K, ERNST E, ET AL.: Dose-re-sponse studies on the effect of n-3 polyunsaturated fatty acids on lipids and hemostasis. Thromb. Haemost. (1990) 63:1–5.
   Google Scholar
• BLONK MC, BELO HJG, NAUTA JJP, ET AL.: Dose-response effects of fish oil supplementation in healthy volun-teers. Am. J. Clin. Nutr. (1990) 52:120–127.
   Google Scholar
• SCHMIDT EB, LERVANG H-H, VARMING K, ET AL.: Long-term supplementation with n-3 fatty adds. I: effects on blood lipids, hemostasis and blood pressure. Scand. J. Clin. Lab. Invest. (1992) 52:221–228.
   Google Scholar
• HARRIS WS, WINDSOR SL: n-3 fatty add supplements reduce chylomicron levels in healthy volunteers. J. Appl. Nutr. (1991) 43:5–15.
   Google Scholar
• BONAA K, BJERVE KS, NORDOY A: Docosahexaenoic andeicosapentaenoic acids in plasma phospholipids are divergently associated with high density lipoprotein in humans. Arterioscler. Thromb. (1992) 12:675–81.
   PubMedGoogle Scholar
• FRANCESCHINI G, CALABRESI L, MADERNA P, ET AL.: (0-3fatty adds selectively raise high-density lipoprotein 2 levels in healthy volunteers. Metabolism (1991) 40:1283–1286.
   Google Scholar
• SANDERS TAB, HINDS A: The influence of a fish oil highin docosahexaenoic acid on plasma lipoprotein and vitamin E concentrations and haemostatic function in healthy male volunteers. Br. J. Nutr. (1992) 68:163–173:
   PubMed Web of Science ®Google Scholar
• MALLE E, SATTLER W, PRENNER E, ET AL.: Effects ofdietary fish oil supplementation on platelet aggregabil-ity and platelet membrane fluidity in nortnolipemic subjects with and without high plasma Lp(a) concen-trations. Atherosclerosis (1991) 88:193–201.
   Google Scholar
• SCHMIDT EB, KLAUSEN IC, KRISTENSEN SD, ET AL.: Theeffect of n-3 polyunsaturated fatty acids on Lp(a). Clin. Chim. Acta (1991) 198:271–278.
   Google Scholar
• SCHMIDT EB, VARMING K, SVANEBORG N, ET AL.: n-3polyunsaturated fatty add supplementation (Pikasol8) in men with moderate and severe hyperlipidaemia: A dose-response study. Ann. Mar. Metab. (1992) 36:283–287.
   Google Scholar
• PHILLIPSON BE, ROTHROCK DW, CONNOR WE, ET AL.: •Reduction of plasma lipids, lipoproteins, and apopro- teins by dietary fish oils in patients with hyper- triglyceridemia. New Engl. J. Med. (1985) 312:1210-1216. A major study showing the great potential of n-3 PUFA to reduce plasma TG in patients with hypertriglyceridaemia.
   Google Scholar
• RICHTER WO, JACOB BG, RD IER MM, ET AL.: Treatmentof primary chylomicronetnia due to familial hyper-triglyceridemia by w-3 fatty acids. Metabolism (1992) 41:1100–1105.
   Google Scholar
• ILLINGWORTH DR, CONNOR WE, HATCHER LF, ET AL.:Hypolipidaemic effects of n-3 fatty acids in primary hyperlipoproteinnemia. J. Intern. Med. (1989) 225\(Suppl. 1):91–97.
   Google Scholar
• FRIDAY KE, FAILOR RA, CHILDS MT, ET AL.: Effects of n-3and n-6 fatty acid-enriched diets on plasma lipoproteins and apolipoproteins in heterozygous familial hyper-cholesterolemia. Arterioscler. Thromb. (1991) 11:47–54.
   Google Scholar
• DAVIDSON MH, BURNS JH, SUBBAIAH PV, ET AL.: Marineoil capsule therapy for the treatment of hyperlipidemia. Arch. Intern. Med. (1991) 151:1732–1740.
   PubMed Web of Science ®Google Scholar
• FAILOR RA, CHILDS MT, BIERMAN EL: The effects of w3and w6 fatty acid-enriched diets on plasma lipoproteins and apoproteins in familial combined hyperlipidemia. Metabolism (1988) 37:1021–1028.
   PubMed Web of Science ®Google Scholar
• TATO F, KELLER C, WOLFRAM G: Effects of fish oil concentrate on lipoproteins and apolipoproteins in familial combined hyperlipidemia. Clin. Investig. (1993) 71:314–318.
   PubMedGoogle Scholar
• DALLONGEVILLE J, BOULET L, DAVIGNON J, ET AL.: Fishoil supplementation reduces 0-very low density lipo-protein in type HI dysbetalipoproteinemia. Arterioscler. Thromb. (1991) 11:864–871.
   Google Scholar
• MOLGAARD J, SCHENK BY, LASSVIK C, ET AL.: Effect offish oil treatment on plasma lipoproteins in type HI hyperlipoproteinaemia. Atherosclerosis (1990) 81:1–9.
   Google Scholar
• VON SCHACKY C, FISCHER S, WEBER PC: Long-term effects of dietary marine w-3 fatty adds upon plasma and cellular lipids, platelet function, and eicosanoid formation in hnmnns. J. Clin. Invest. (1985) 76:1626–1631.
   PubMed Web of Science ®Google Scholar
• KNAPP HR, REILLY IAG, ALESSANDRINI P, ET AL.: In vivoIndexes of platelet and vascular function during fish-oil administration in patients with atherosderosis. New Engl. J. Med. (1986) 314:937–942.
   Google Scholar
• KRISTENSEN SD, SCHMIDT EB, DYERBERG J: Dietary supplementation with n-3 polyunsaturated fatty acidsand human platelet function: A review with particular emphasis on implications for cardiovascular disease. J. Intern. Med. (1989) 225\(Suppl. 1):141–150. A review on the effects of n-3 PUFA on platelet function.
   Google Scholar
• GOODNIGHT SH, HARRIS WS, CONNOR WE: The effects of dietary w3 fatty adds on platelet composition and function in man: A prospective, controlled study. Blood (1981) 58:880–885.
   PubMed Web of Science ®Google Scholar
• TERANO T, HIRAI A, HAMAZAKI T, ET AL.: Effect of oraladministration of highly purified eicosapentaenoic acid on platelet function, blood viscosity and red cell deformability in healthy human subjects. Atherosclerosis (1983) 46:321–331.
   Google Scholar
• LI X, STEINER M: Fish oil: A potent inhibitor of platelet adhesiveness. Blood (1990) 76:938–945.
   PubMed Web of Science ®Google Scholar
• LI X, STEINER M: Dose response of dietary fish oil supplements on platelet adhesiveness. Arterioscler. Thromb. (1991) 11:39–46.
   PubMedGoogle Scholar
• LAGARDE M, CROSET M, VÉRICEL E, ET AL.: Effects of small concentrations of eicosapentaenoic acid on plate-lets. J. Intern. Med. (1989) 225\(Suppl. 1):177–179.
   Google Scholar
• WINTHER K, MYRUP B, HOJ C, ET AL.: Decreased platelet reactivity without change in flbrinolytic activity after low dosages of fish oil. Angiology (1993) 22:39–44.
   Google Scholar
• THORNGREN M, GUSTAFSON A: Effects of 11-week in-crease in dietary eicosapentaenoic add on bleeding time, lipids, and platelet aggregation. Lancet (1981) 11:1190–1193.
   Google Scholar
• HARRIS WS, SILVEIRA S, DUJOVNE CA: The combined effects of n-3 fatty acids and aspirin on hemostatic parameters in man. Thromb. Res. (1990) 57:517–526.
   PubMed Web of Science ®Google Scholar
• VANHOUITE PM, SHIMOKAWA H, BOULANGER C: Fish oil and the platelet-blood vessel wall interaction. World Rev. Nutr. Diet (1991) 66:233-244. A review documenting that n-3 PUFA increase EDRF production.
   Google Scholar
• LORENZ RL, SPENGLER U, FISCHER S, ET AL.: Platelet function, thromlboxane formation and blood pressure control during supplementation of the western diet with cod liver oil. Circulation (1983) 67:504–511.
   Google Scholar
• KENNY D, WARLTIER DC, PLEUSS JA, ET AL.: Effect of omega-3 fatty acids on the vascular response to angiotensin in normotensive men. Am. J. Cardiol. (1992) 70:1347–1352.
   Google Scholar
• FLEISCHFIAUER FJ, YAN W-D, FISCHELL TA: Fish oil im-proves endothelium-dependent coronary vasodilation in heart transplant recipients. J. Am. Coll. Cardiol. (1993) 21:982–989.
   PubMed Web of Science ®Google Scholar
• CHIN JPF, GUST AP, NESTEL PJ, ET AL.: Marine oil dose-dependently inhibits vasoconstriction of forearm resis-tance vessels in humans. Hypertension (1993) 21:22–28.
   Google Scholar
• FOX PL, DICORLETO PE: Fish oils inhibit endothelial cell production of platelet-derived growth factor-like pro-tein. Science (1988) 241:453-456. This study shows that n-3 PUFA reduce endothelial production of PDGF in vitro.
   Google Scholar
• FOX PL, SALVATORE MF: Serum factor that blocks the action of fish oils on endothelial cell production of platelet-derived growth factor is ceruloplasmin. Lab. Invest. (1992) 66:467–473.
   PubMed Web of Science ®Google Scholar
• KAMINSICY WE, JENDRASCHAK E, KIEFL R, ET AL.: Dietary w-3 fatty adds lower levels of platelet-derived growth factor mRNA in human mononuclear cells. Blood (1993) 81:1871-1879. A recent interesting study showing that gene expression of PDGF may be reduced by n-3 PUFA.
   Google Scholar
• SMITH DL, WILLIS AL, NGUYEN N, ET AL.: Eskimo plasma constituents, dihomolinolenic acid, eicosapentaenoic acid and docosahexaenoic add inhibit the release of atherogenic mitogens. Lipids (1989) 24:70–75.
   Google Scholar
• LEE TH, HOOVER RE, WILLIAMS JD, ET AL.: Effects of dietary enrichment with eicosapentaenoic add anddocosahexaenoic adds on in vitro neutrophil and monocyte leukotriene generation and neutrophil func-tion. New Engl. J. Med. (1985) 312:1217-1224. The first major study in humans showing that leukocyte reactivity is reduced by n-3 PUFA.
   Google Scholar
• SPERLING RJ, BENINCASO Al, KNOELL CT, ET AL.: Dietary w-3 polyunsaturated fatty adds inhibit phosphoinosi-tide formation and chemotnxis in neutrophils. J. Clin. Invest. (1993) 91:651–660.
   Google Scholar
• SCHMIDT EB, PEDERSEN JO, EKELUND SE, ET AL.: Cod liver oil inhibits neutrophil and monocyte chemotaxis In healthy males. Atherosclerosis (1989) 77:53–57.
   Google Scholar
• SCHMIDT EB, VARMING K, PEDERSEN JO, ET AL.: Long-term supplementation with n-3 fatty acids, Effect on neutrophil and monocyte chemotaxis. Scand. J. Clin. Lab. Invest. (1992) 52:229–236.
   Google Scholar
• SCHMIDT EB, PEDERSEN JO, VARMING K, ET AL.: n-3 fatty acids and leukocyte chemotaxis: Effects in hyper-lipidemia and dose-response studies in healthy men. Arteriosclerosis Thromb. (1991) 11:429–435.
   Google Scholar
• ENDRES S. GHORBANI R, KELLEY YE, ET AL.: The effect of dietary supplementation with n-3 polyunsaturated fattyadds on the synthesis of interleukin-1 and tumor ne-crosis factor by mononuclear cells. New Engl. J. Med. (1989) 320:265-271. The first demonstration that n-3 PUFA reduce cytokine production from mononuclear cells.
   Google Scholar
• MEYDANI SN, LICHTENSTEIN AH, COLWELL S, ET AL.: Immunologic effects of national cholesterol education panel step-2 diets with and without fish-derived n-3 fatty acid enrichment. J. Clin. Invest. (1993) 92:105-113. A recent comprehensive study on the effects of a diet enriched with low amounts of n-3 PUFA on immune function.
   Google Scholar
• FISHER M, LEVINE PH, WEINER BH, ET AL.: Dietary n-3 fatty acid supplementation reduces superoxide produc-tion and chemiluminescence in a monocyte-enriched preparation of leukocytes . Am .J . Clin. Nutr. (1990) 51:804–808.
   Google Scholar
• LEHR H-A, HUBNER C, FINCKH B, ET AL.: Dietary fish oil reduces leukocyte/endothelium interaction following systemic administration of oxidatively modified low density lipoprotein. Circulation (1991) 84:1725–1731.
   Google Scholar
• FISHER M, UPCHURCH KS, LEVINE PH, ET AL.: Effects of dietary fish oil supplementation on polymorphonu-dear leukocyte inflammatory potentiaL Inflammation (1986) 10:387–392.
   Google Scholar
• SINGER P: Blood-pressure lowering effect of mackerel diet. lain. Wochenschr. (1990) 68\(Suppl. 20):40–48.
   Google Scholar
• APPEL LJ, MILLER ER, SEIDLER AJ, ET AL.: Does supplemen- tation of diet with fish oil reduce blood pressure. Arch. Intern. Med. (1993) 153:1429–1438.
   Google Scholar
• SO
   Google Scholar
• Oa • A recent overview on the effects of n-3 PUFA on blood pressure.
   Google Scholar
• NORRIS PG, JONES CJH, WESTON MJ: Effect of dietary supplementation with fish oil on systolic blood pres-sure hi mild essential hypertension. BMJ (1986) 293:104–105.
   PubMed Web of Science ®Google Scholar
• KNAPP HR, FITZGERALD GA: The antihypertensive ef-fects of fish oil. New Engl. J. Med. (1989) 320:1037–1043.
   PubMed Web of Science ®Google Scholar
• BONAA KH, BJERVE KS, STRAUME B, ET AL.: Effect of •eicosapentaenoic and docosahexaenoic acids on bloodpressure in hypertension. New Engl. J. Med. (1990) 322:795-801. A major study showing an antihypertensive effect of n-3 PUFA.
   Google Scholar
• RADACK K, DECK C, HUSTER G: The effects of low doses of n-3 fatty acid supplementation on blood pressure hi hypertensive subjects. Arch. Intern. Med. (1991) 151:1173–1180.
   PubMed Web of Science ®Google Scholar
• LEVINSON PD, IOSIPHIDIS AH, SARITELLI AL, ET AL.: Effects of n-3 fatty acids in essential hypertension. Am. J. Hypertens. (1990) 3:754–760.
   Google Scholar
• HUGHES GS, RINGER TV, WATTS KC, ET AL.: Fish oil produces an atherogenic lipid profile in hypertensive men. Atherosclerosis (1990) 84:229–237.
   Google Scholar
• LOFGREN RP, WILT TJ, NICHOL KL, ET AL.: The effect of fish oil supplements on blood pressure. Am. J. Public Health (1993) 83:267–269.
   PubMed Web of Science ®Google Scholar
• WING LMH, NESTEL PJ, CHALMERS JP, ET AL.: Lack of effect of fish oil supplementation on blood pressure in treated hypertensives. J. Hypertens. (1990) 8:339–343.
   Google Scholar
• COLWELL JA, FRANZ MJ, GINSBERG H, ET AL.: Role of cardiovascular risk factors in prevention and treatment of macrovascular disease in diabetes. Diabetes Care (1989) 12:573–579.
   Google Scholar
• BIERMAN EL: Atherogenesis in diabetes. Arterioscler. Thromb. (1992) 12:647–656.
   PubMed Web of Science ®Google Scholar
• SCHMIDT EB, SORENSEN PJ, PEDERSEN JO, ET AL.: The effect of n-3 polyunsaturated fatty acids on lipids, haemostasis, neutrophil and monocyte chemotaxis in Insulin-dependent diabetes mellitus. J. Intern. Med. (1989) 225\(Suppl. 1):201–206.
   Google Scholar
• STACPOOLE PW, ALIG J, AMMON L, ET AL.: Dose-response effects of dietary marine oil on carbohydrate and lipid metabolism in normal subjects and patients with hy-pertriglyceridemia. Metabolism (1989) 38:946–956.
   Google Scholar
• RILLAERTS EG, ENGELMANN GJ, VAN CAMP KM, ET AL.: Effect of Omega-3 fatty acids in diet of type I diabetic subjects on lipid values and hemorheological parame-ters. Diabetes (1989) 38:1412–1416.
   Google Scholar
• JENSEN T, STENDER S, GOLDSTEIN K, ET AL.: Partial normalization by dietary cod-liver oil of increased microvascular albumin leakage in patients with insu-lin-dependent diabetes and albuminuria. New Engl. J. Med. (1989) 321:1572-1577. This interesting study shows that n-3 PUFA may improve cell permeability in patients with IDDM.
   Google Scholar
• LANDGRAF-LEURS MMC, DRUMMER C, FROSCHL H, ET AL.: Pilot study on w-3 fatty acids in type I diabetes mellitus. Diabetes (1990) 39:369–375.
   Google Scholar
• BAGDADE JD, BUCHANAN WE, LEVY RA, ET AL.: Effects of w-3 fish oils on plasma lipids, lipoprotein composi-tion, and postheparin lipoprotein lipase in women with IDDM. Diabetes (1090) 39:426–431.
   Google Scholar
• MORI TA, VANDONGEN R, MASAREI JRL: Fish oil-induced changes in apolipoproteins in IDDM subjects. Diabetes Care (1990) 13:725–732.
   PubMed Web of Science ®Google Scholar
• MORI TA, VANDONGEN R, MASAREI JRL, ET AL.: Compari-son of diets supplemented with fish oil or olive oil on plasma lipoproteins in insulin-dependent diabetics. Metabolism (1991) 40:241–246.
   Google Scholar
• HAINES AP, SANDERS TAB, IMESON JD, ET AL.: Effects of a fish oil supplement on platelet function, haemostatic variables and alliu.minuria in insulin-dependent diabet-ics. Thromb. Res. (1986) 43:643–655.
   Google Scholar
• HORNSTRA G: The effect of n-3 fatty acids on blood coagulation. In: Fish oil and vascular disease. Caterina RD, Kristensen SD, Schmidt EB (Eds.). Springer-Verlag (1992):65–72 [Current topics in cardiovascular disease. Crepaldi G (Ed.)].
   Google Scholar
• SCHMIDT EB: n-3 fatty acids and fibrinolysis. In: Fish oil and vascular disease. Caterina RD, Kristensen SD, Schmidt • EB (Eds.). Springer-Verlag (1992):73–77 [Current topics in cardiovascular disease. Crepaldi G (Ed.)1. This review documents the finding that n-3 PUFA may inhibit fibrinolysis.
   Google Scholar
• MARCKMANN P, JESPERSEN J, LETH T, ET AL.: Effect of fish diet versus meat diet on blood lipids, coagulation and fibrinolysis in healthy young men. J. Intern. Med. (1991) 229:317-323. An extensive examination of the effect of n-3 PUFA on coagulation and fibrinolysis.
   Google Scholar
• EMEIS JJ, VAN HOUWELINGEN AC, VAN DEN HOOGEN CM, ET AL.: A moderate fish intake increases plasmino-gen activator inhibitor type-1 in healthy volunteers. Blood (1989) 74:233–237.
   Google Scholar
• IACOVIELLO L, AMORE C, DE CURTIS A, ET AL.: Modula-tion of fibrinolytic response to venous occlusion in humans by a combination of low-dose aspirin and n-3 polyunsaturated fatty adds. Arterioscler. Thromb. (1992) 12:1191–1197.
   Google Scholar
• BARCELLI U, GLAS-GREENWALT P, POLLAK VE: Enhanc-ing effect of dietary supplementation with w-3 fatty acids on plasma fibrinolysis in normal subjects. Thromb. Res. (1985) 39:307–312.
   PubMed Web of Science ®Google Scholar
• SAYNOR R, VEREL D, GILLUM- T: The long term effect of dietary supplementation with fish lipid concentrate on serum lipids, bleeding time, platelets and angina. Atherosclerosis (1984) 50:3–10.
   PubMed Web of Science ®Google Scholar
• KRISTENSEN SD, SCHMIDT EB, ANDERSEN HR, ET AL.: Fish oil in angina pectoris. Atherosclerosis (1987) 64:13–19.
   Google Scholar
• VERHEUGHT FWA, SCHOUTEN JA, EELTINK JC, ROOS JP: Omega-3 fatty acids in the treatment of angina pectoris: effect on objective signs of exercise-induced myocar-dial ischaemia. Current Therapeutic Research (1986) 39:208–213.
   Web of Science ®Google Scholar
• MEHTA JL, LOPEZ LM, LAWSON D, ET AL.: Dietary supple-mentation with omega-3 polyunsaturated fatty acids in patients with stable coronary heart disease. Am. J. Med. (1988) 84:45–52.
   Google Scholar
• SOLOMON S, CARTWRIGHT I, POCKLEY G, ET AL.: A placebo-controlled, double-blind study of eicosapen-taenoic acid-rich fish oil in patients with stable angina pectoris. Curr. Med. Res. Opin. (1990) 12:1-11. OS
   Google Scholar
• KRISTENSEN SD, DE CATERINA R, SCHMIDT EB, ET AL.: Fish oil and ischaemic heart disease. Br. Heartj. (1993) 70:212-214. A recent short review on the effects of n-3 PUFA in patients with CAD.
   Google Scholar
• BURR ML, FEHILY AM, GILBERT JF, ET AL.: Effects of changes in fat, fish, and fibre intakes on death andmyocardial reinfarction: Diet and reinfarction trial (DART). Lancet (1989) 11:757-761. A landmark trial showing a reduced two-year mortality in post-AMI patients eating fish.
   Google Scholar
• CHARNOCK JS: Antiarrhythmle effects of fish oils. World
   Google Scholar
• Rev. Nutr. Diet (1991) 66:278-291. A recent review on the anti-arrhythmic effect of n-3 PUFA in animals.
   Google Scholar
• MCLENNAN PL: Relative effects of dietary saturated, monounsaturated, and polyunsaturated fatty adds on cardiac arrhythmias in rats. Am. J. Clin. Nutr. (1993) 57:207–212.
   PubMed Web of Science ®Google Scholar
• HALLAQ H, SMITH TW, LEAF A: Modulation of dihy-dropyridine-sensitive calcium channels in heart cells by fish oil fatty acids. Proc. Natl. Acad. Sci. USA (1992) 89:1760–1764.
   PubMed Web of Science ®Google Scholar
• HARDARSON T, KRISTINSSON A, SKULADOTTIR G, ET AL: Cod liver oil does not reduce ventricular extrasystoles after myocardial infarction. J. Intern. Med. (1989) 226:33–
   PubMed Web of Science ®Google Scholar
• CHRISTENSEN JH, GUSTENHOFF P, EJLERSEN E, ET AL:. The effect of n-3 polyunsaturated fatty adds on cardiac ventricular arrhythmias - a pilot study. In n-3 fatty acids and vascular disease. De Caterina R, Endres S, Kristensen SD, Schmidt EB (Eds.). Springer-Verlag (1993):151–157.
   Google Scholar
• DEHMER GJ, POPMA p, VAN DEN BERG EK, ET AL.: Reduction lathe rate of early restenosis after coronary angioplasty by a diet supplemented with n-3 fatty acids. New Engl. J. Med. (1988) 319:733–740.
   Google Scholar
• REIS GJ, SIPPERLY ME, MCCABE CH, ET AL.: Randomised trial of fish oil for prevention of restenosis after coro-nary angioplasty. Lancet (1989) II:177–181.
   Google Scholar
• GRIGG LE, KAY TWH, VALENTINE PA, ET AL.: Determi-nants of restenosis and lack of effect of dietary supple-mentation with eicosapentaenoic add on the incidence of coronary artery restenosis after angioplasty. J. Am. Coll. Cardiol. (1989) 13:665–672.
   Google Scholar
• BAIRATI I, ROY L, MEYER F: Double-blind, randomized, controlled trial of fish oil supplements in preventionof recurrence of stenos's after coronary angioplasty. Circulation (1992) 85:950-956. This well-conducted study shows beneficial effects of n-3 PUFA on restenosis after PTCA.
   Google Scholar
• SLACK JD, PINKERTON CA, VANTASSEL J, ET AL.: Can oral fish oil supplement tninbra7e restenosis after percu-taneous angioplasty? [Abstract]. J. Am. Coll. Cardiol. (1987) 9:64A.
   Google Scholar
• MILNER MR, GALLINO RA, LEFFINGWELL A, ET AL.: Useful-ness of fish oil supplements in preventing clinical evidence of restenosis after percutaneous transluminal angioplasty. Am. J. Cardiol. (1989) 64:294–299.
   Google Scholar
• NYE ER, ILSLEY CDJ, ABLETT MB, SUTHERLAND W, ROBERTSON MC: Effect of eicosapentaenoic acid on restenosis rate, clinical course and blood lipids in patients after percutaneous transbunirml angioplasty. Austr. NZ J. Med. (1990) 20:549–552.
   PubMedGoogle Scholar
• KALTL U, SANGHVI S, BAHL VK, DEV V, WASIR HS: Fish oil supplements for prevention of restenosis after coro-nary angioplasty. Int. J. Cardiol. (1992) 35:87–93.
   PubMed Web of Science ®Google Scholar
• FRANZEN D, SCHANNWELL M, OEflh K, HOPP HW: A prospective, randomized, and double-blind trial on the effect of fish oil on the incidence of restenosis following PTCA.. Catheterization and Cardiovascular Diagnosis (1993) 28:301–310.
   PubMedGoogle Scholar
• O'CONNOR GT, MALENKA DJ, OLMSTEAD EM, JOHNSON PS, HENNEKENS CH: A metaanalysis of randomized trials of fish oil in prevention of restenosis following coro-nary angioplasty. Am. J. Prey. Med. (1992) 8:186–192.
   PubMed Web of Science ®Google Scholar
• ROY L, MEYER F, GINGRAS L, AUGER L: A double-blind randomized controlled trial comparing the efficacy of fish oil and low dose ASA to prevent coronary saphe-nous vein graft obstrcution after CABG. Circulation (1991) 84\(Suppl. 11):285A.
   Google Scholar
• ERITSLAND J, ARNESEN H, GRONSETH, FJELD NB, ABDEL-NOOR M: Effect of supplementation with n-3 fatty adds on graft patency in patients undergoing coronary ar-tery bypass operation. Results from the SHOT study [Abstract]. Eur. Heart. J. (1994) 15(Suppl.): 351A.
   Google Scholar
• BARBIR M, HUNT B, KUSHWAHA S, ETAL.: Maxepa versus bezafibrate in hyperlipidemic cardiac transplant recipi-ents. Am. J. Cardiol. (1992) 70:1596–1601.
   Google Scholar
• VENTURA HO, MILANI RV, LAVIE CJ, ET AL.: Cyclospor-ine-induced hypertension. Efficacy of omega-3 fatty adds in patients after cardiac transplantation. Circula-tion (1993) 88:281–285.
   Google Scholar
• SCHMIDT EB, KRISTENSEN SD, DYERBERG J: The effect of fish oils on lipids, coagulation and fibrinolysis in pa-tients with angina pectoris. Artery (1988) 15:316–329
   PubMedGoogle Scholar
• SMITH P, ARNESEN H, OPSTAD T, ET AL.: Influence of highly concentrated n-3 fatty adds on serum lipids and hemostatic variables In survivors of myocardial in-farction receiving either oral anticoagulants or match-ing placebo. Thromb. Res. (1989) 53:467–474.
   Google Scholar
• DE CATERINA R, GIANNESSI D, MAZZONE A, ET AL.:
   Google Scholar
• Vascular prostacyclin is increased in patients ingesting(.13–3 polyunsaturated fatty acids before coronary artery bypass graft surgery. Circulation (1990) 82:428-438. An interesting study showing beneficial effects of n-3 PUFA on biochemical variables in patients scheduled for coronary bypass surgery.
   Google Scholar
• HAY CRM, SAYNOR R, DURBER AP: Effect of fish oil on platelet kinetics in patients with ischaemic heart dis-ease. Lancet (1982) L1269–1272.
   Google Scholar
• NILSEN DWT, DALAKER K, NORDOY A, ET AL.: Influence of a concentrated ethylester compound of n-3 fatty acids on lipids, platelets and coagulation in patients undergoing coronary bypass surgery. Ihromb. Haemost. (1991) 66:195–201.
   Google Scholar
• MA1ANASOS TH, STACPOOLE PW: Biological effects of omega-3 fatty acids in diabetes mellitus. Diabetes Care (1991) 14:1160-1179. An extensive review on the effects of n-3 PUFA in patients with diabetes.
   Google Scholar
• HARATS D, DABACH Y, HOLLANDER G, ET AL.: Fish oil Ingestion in smokers and nonsmokers enhances per-oxidation of plasma lipoproteins. Atherosclerosis (1991) 90:127–139.
   Google Scholar
• ••
   Google Scholar
• ••
   Google Scholar
• MEYDANI M, NATIELLO F, GOLDIN B, ET AL.: Effect of long-term fish oil supplementation on vitamin E status and lipid peroxidation in women. J. Nutr. (1991) 121 :484–491 .
   Google Scholar
• NELSON GJ, MORRIS VC, SCHMIDT PC, ET AL.: The urinary excretion of thiobarbituric add reactive substances and malondialdehyde by normal adult males after consum-ing a diet containing salmon. Lipids (1993) 28:757–761.
   Google Scholar
• NAIR PP, JUDD JT, BERLIN E, ET AL.: Dietary fish oil-in-duced changes in the distribution of a-tocopherol, retinol, and R-carotene in plasma, red blood cells, and platelets: modulation by vitamin E. Am. j Clin. Nutr. (1993) 58:98–102.
   Google Scholar
• NENSETER MS, RUSTAN AC, LUND-KATZ S, ET AL.: Effect of dietary supplementation with n-3 polyunsaturated fatty adds on physical properties and metabolism of low density lipoprotein in humans. Arterioscler. Tbromb. (1992) 12:369–379.
   Google Scholar
• HAGLUND 0, LUOSTARINEN R, WALLIN R, ET AL.: The effects of fish oil on triglycerides, cholesterol, fibrino-gen and malondialdehyde in humans supplemented with vitamin E. J. Nutr. (1991) 121:165–169.
   Google Scholar
• OLIVIER! 0, NEGRI M, DE GIRONCOLI M, ET AL.: Effects of dietary fish oil on malondialdehyde production and glutathione peroxidase activity in hyperlipidaemic patients. Scand. J. Clin. Lab. Invest. (1988) 48:659–665.
   Google Scholar
• COFtROCHER R, FERRARI S, DE GIRONCOLI M, ET AL.: Effect of fish oil supplementation on erythrocyte lipid pattern, malondialdehyde production and gluthathione-peroxidase activity in psoriasis. Clin. Chim. Acta (1989) 179:121–132.
   Google Scholar
• CLARICE JTR, CULLEN-DEAN C, REGELINK E, ET AL.: In-creased incidence of epistaxis in adolescents with fa-milial hypercholesterolemia treated with fish oil. J. Pediatr. (1990)116:139–141.
   PubMed Web of Science ®Google Scholar
• SCHMIDT EB, DYERBERG J: n-3 fatty acids and leucocytes. Intern. Med. (1989) 225\(Supp1.1):151–158.
   Google Scholar
• OGDEN P, PIZIAK VK, CAIN PT, ETAL.: Reactive lymphoid hyperplasia after omega-3 fatty acid supplementation. Ann. Intern. Med. (1988) 109:843–844.
   Google Scholar
• SVENSSON B-G, NILSSON A, HANSSON M, ET AL.: Expo-sure to dioxins and dibenzofurans through the con-sumption of fish. New Engl. J. Med. (1991) 324:8–12.
   Google Scholar