The reduction of hypertension through dietary flaxseed intervention and the identification of oxylipins as therapeutic targets in cardiovascular disease

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Date
2014, 2014, 2014, 2014
Authors
Caligiuri, Stephanie
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Publisher
Springer
Elsevier
Lippincott Williams & Wilkins
BioMed Central
Abstract
Dietary flaxseed is a Manitoban crop rich in the n3 fatty acid alpha-linolenic acid, fibre and antioxidant lignans. Addition of flaxseed to the diet decreased brachial blood pressure in patients with hypertension and peripheral artery disease over one year (n=110). With the addition of flaxseed to standard of care, 21% of patients improved from blood pressure above goal (>140/90 mmHg) to blood pressure within goal (<140/90 mmHg). Dietary flaxseed may have induced these anti-hypertensive effects through the reduction of vascular constriction and inflammation. Healthy older adults, who consumed flaxseed every day for 4 weeks, exhibited significantly decreased concentrations of plasma pro-inflammatory oxylipins such as 5-hydroxyeicosatetraenoic acid and trihydroxyoctadecenoic acid. In patients with hypertension and peripheral artery disease, flaxseed consumption for 1 year significantly decreased plasma oxylipins that are responsible for propagating inflammation and vascular constriction. The oxylipins that decreased in the flaxseed group were all produced by the same enzyme, soluble epoxide hydrolase. Alpha-linolenic acid decreased soluble epoxide hydrolase activity in an activity assay. Thus, flaxseed may exert its anti-hypertensive effects through an inhibition of soluble epoxide hydrolase by alpha-linolenic acid. Flaxseed also induced a significant decrease in central aortic blood pressure without cardiac or arterial elasticity involvement as measured by pulse wave analysis. Some of the same oxylipins that decreased with flaxseed consumption were significantly associated with higher central aortic blood pressure and a higher prevalence of cardiovascular and cerebrovascular events in patients with peripheral artery disease. Every 1 nM increase in plasma 16-hydroxyeicosatetraenoic acid increased the odds of a stroke by 55-fold, thus indicating the potential of particular oxylipins to act as diagnostic markers or therapeutic targets. New research is currently investigating if dietary flaxseed can lower blood pressure and prevent the need for anti-hypertensive medications in those newly diagnosed with hypertension. The implications of this research may change how standard of care is implemented for patients with hypertension and cardiovascular disease. The goal is to offer patients an additional effective strategy beyond anti-hypertensive medications for the management of hypertension in order to reduce the risk of cardiovascular events and to improve patient care and quality of life.
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Keywords
Hypertension
Citation
2) Caligiuri SPB., Edel A., Aliani M., Pierce GN. Flaxseed for hypertension: implications for blood pressure regulation. Curr Hypertens Rep. 2014 Dec;16(12):499.
3) Caligiuri SPB., Aukema H., Ravandi A, Pierce GN. Elevated levels of pro-inflammatory oxylipins in older subjects are normalized by flaxseed consumption. Experimental Gerontology. 2014 Nov;59:51-7
4) Caligiuri SPB., Aukema H., Dibrov E., Guzman R., Ravandi A, Pierce GN. Flaxseed consumption reduces blood pressure in patients with hypertension by altering circulating oxylipins via an alpha-linolenic acid induced inhibition of soluble epoxide hydrolase. Hypertension. 2014 Jul;64(1):53-9.
7) Caligiuri SPB., Penner B., Pierce GN. The HYPERFlax Trial: Determining the anti-HYPERtensive effects of dietary Flaxseed in newly diagnosed Stage 1 hypertensive patients using a parallel, phase II, randomized, controlled, double-blinded clinical trial. Trials. 2014;Jun 18;15:232.