Abstract P273: Omega-3 Fatty Acids in Erythrocyte Membranes are Associated With Predictive Equations for Estimation of Cardiovascular Risk in Brazilian Individuals

Introduction: Although several mechanisms confirm the cardioprotective role of omega-3 fatty acids (n-3 PUFA), there is still controversy regarding its impact on cardiovascular outcomes. We hypothesized that the n-3 PUFA in erythrocytes membranes reflect better intake and metabolization of these fatty acids, allowing identify their cardiovascular benefits. Objective: To evaluate the association of the n-3 PUFA with cardiometabolic biomarkers and absolute cardiovascular risk. Methods: A crossectional study based on the baseline time of CARDIONUTRI clinical trial (n = 356) with individuals of both sexes (30-74 years) who showed at least one of the following risk factors: smoking, hypertension, dyslipidemias, diabetes mellitus or obesity, but without previous cardiovascular events, monitored by clinical evaluation and ECG. By direct interviews, information about demographic data, medication, blood pressure, diet, and physical activity were investigated by physician and dietician. After 12h of fasting, the lipid profile, lipoprotein sub fractions, LDL(-), glucose, HbA1c, insulin, HOMA-IR and inflammation biomarkers were analyzed by standard and validated methods. After lipid extraction from erythrocytes, fatty acids were analyzed by gas chromatography using internal (C17) and external (FAME 37) standard. The 10-years projection of absolute cardiovascular risk was estimated by the Framingham (FRS), Reynolds (RRS) and ACC/AHA 2013 risk scores. Association between fatty acids, biomarkers and cardiovascular risk scores were performed by linear and logistic regression models and factorial analysis (SPSS v.20.0 and Stata v.14.0). Results: Individuals with n-3 PUFA > 6.24% and n-6/n-3 ≤ 1.27 had less plasma non-HDL cholesterol, Apo B, TG, LDL(-) and highest LDL size. Regarding FRS, the total n-3 PUFA had association with lower cardiovascular risk (OR=0.811; IC95%=0.675- 0.976) and the membrane 1 model rich in n-6 was and poor in n-3 PUFA was associated with higher risk (OR=1.469; IC95%=1.056-2.043). Regarding RRS, the same membrane model was associated with higher risk (OR: 1.276; IC95%=1.010-1.612) while the opposite pattern was observed for membrane 2 model (rich in n-3 and poor in n-6 PUFA), had association with lower risk (OR=0,747; IC95%=0,589-0,948). Conclusion: High content of n-3 in erythrocyte membranes containing was associated with a lipid profile characterized by less plasma atherogenic lipoproteins, reduced TG and modified LDL. This profile was associated with reduced chance to be classified as moderate or higher cardiovascular risk by the Reynolds and Framingham Risk Scores.

Essential hypertension: Definition, epidemiology, and pathophysiology

‘Essential hypertension’ is high blood pressure for which there is no clearly defined aetiology. From a practical perspective, it is best defined as that level of blood pressure at which treatment to lower blood pressure results in significant clinical benefit—a level which will vary from patient to patient depending on their absolute cardiovascular risk. Historically, most guidelines define ‘hypertension’ as an office blood pressure greater than or equal to 140/90 mm Hg, but some recent recommendations prefer home or ambulatory blood pressure (blood pressure) averages. When using 24 h ambulatory blood pressure or home blood pressure averages to define hypertension, the diagnostic thresholds are lower than those used with office measurement, with a value of 135/85 mm Hg typically used for both daytime ambulatory blood pressure and home measurements.