From the Department of Medicine, The University of Western Australia, and
The Western Australian Heart Research Institute, Perth, Australia.
Abstract—Obesity is a major
factor contributing to hypertension and increased risk of
cardiovascular disease. Regular consumption of dietary
fish and
© 1998 American Heart Association, Inc.
Scientific Contributions
Effects of Dietary Fish and Weight Reduction on Ambulatory Blood Pressure in Overweight Hypertensives
3 fatty acids of marine origin can lower blood pressure
(BP) levels and reduce cardiovascular risk. This study
examined the potential effects of combining dietary fish rich in 3
fatty acids with a weight loss regimen in overweight hypertensive
subjects, with ambulatory BP levels as the primary end point. Using a
factorial design, 69 overweight medication-treated hypertensives were
randomized to a daily fish meal (3.65 g 3 fatty acids), weight
reduction, the 2 regimens combined, or a control regimen for 16 weeks.
Sixty-three subjects with a mean±SEM body mass index of 31.6±0.5
kg/m2 completed the study. Weight fell by 5.6±0.8 kg with
energy restriction. Dietary fish and weight loss had significant
independent and additive effects on 24-hour ambulatory BP. Effects were
greatest on awake systolic and diastolic BP
(P<0.01); relative to control, awake pressures fell
6.0/3.0 mm Hg with dietary fish alone, 5.5/2.2 mm Hg with
weight reduction alone, and 13.0/9.3 mm Hg with fish and weight
loss combined. These results also remained significant after further
adjustment for changes in urinary sodium, potassium, or the
sodium/potassium ratio, as well as dietary macronutrients. Dietary fish
also significantly reduced 24-hour (-3.1±1.4 bpm,
P=0.036) and awake (-4.2±1.6 bpm,
P=0.013) ambulatory heart rates. Weight reduction had a
significant effect on sleeping heart rate only (-3.2±1.7 bpm,
P=0.037). Combining a daily fish meal with a
weight-reducing regimen led to additive effects on ambulatory BP and
decreased heart rate. The effects were large, suggesting that
cardiovascular risk and antihypertensive drug
requirements are likely to be reduced substantially by combining
dietary fish meals rich in 3 fatty acids with weight-loss regimens
in overweight medication-treated hypertensives. The reduction in heart
rate seen with dietary fish suggests a cardiac/autonomic component, as
well as vascular effects, of increased consumption of 3 fatty acid
from fish.
Key Words: fish • 3 fatty acids • weight control • blood pressure • obesity
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