Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Hypertension prevention: from nutrients to (fortified) foods to dietary patterns. Focus on fatty acids

Journal of Human Hypertension volume 19, pages S25–S33 (2005)Cite this article

Abstract

Diet affects significantly the incidence and severity of cardiovascular diseases and fatty acid intake, in its qualitative as well as quantitative aspects, and influences several risk factors including cholesterol (total, LDL and HDL), triglycerides, platelet aggregation and blood pressure, as evidenced in the 2001 WHO report. This review focuses on the qualitative concern of lipid intake, the various classes of fatty acids of the lipid fraction of the diet, saturated, monounsaturated and polyunsaturated, and their effects on blood pressure. Saturated fat have a bad file and several experimental studies in the rat showed a progressive increase in blood pressure in response to a highly saturated diet. Moreover, a highly saturated diet during gestation led to offspring which, when adults, presented a gender-related hypertension. The mechanism of this effect may be related to the polyunsaturated/saturated ratio (p/s). During the past 20 years, trans fatty acids have been suspected of deleterious health effects, but the investigations have shown that these fatty acids display a biological behaviour close to that of saturated fatty acids (SFA). Moreover, epidemiological investigations did not confirm the relationship between trans fatty acids and cardiovascular pathology. Polyunsaturated fatty acids have been shown to exert a positive action on hypertension. This effect could be attributed to the alteration of the p/s, but mainly to the ω3 polyunsaturated fatty acids (PUFAs). The comparison of several animal models led to the conclusion that long-chain ω3 PUFAs (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)) can prevent the increase in blood pressure and reduce established hypertension, but the efficient dose remains an object of discussion. Moreover, the two long-chain ω3 PUFAs, EPA and DHA, display specific effects, which vary with the aetiology of hypertension, because their mechanism of action is different. DHA acts on both blood pressure and heart function (heart rate and ECG) and interferes with the adrenergic function. Conversely, EPA, which is not incorporated in cardiac phospholipids, has no effect on the heart and its mechanism of action is largely unknown. Although it is accepted by the scientific community that the intake of EPA and DHA needs to be increased, we will have to discover new ways to do it, since marine products are the main source of these fatty acids, and this source is not inexhaustible.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others

References

  1. Cody RJ . The sympathetic nervous system and the renin–angiotensin–aldosterone system in cardiovascular disease. Am J Cardiol 1997; 80: 9J–14J.

    Article  CAS  Google Scholar 

  2. The sixth report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Arch Intern Med 1997; 157: 2413–2446.

  3. WHO. World Health Organization – International Society of Hypertension Guidelines for the Management of Hypertension, Guidelines Subcommittee. J Hypertens 1999; 17: 151–183.

  4. Safar ME, London GM . Therapeutic studies and arterial stiffness in hypertension: recommendations of the European Society of Hypertension. The Clinical Committee of Arterial Structure and Function. Working Group on Vascular Structure and Function of the European Society of Hypertension. J Hypertens 2000; 18: 1527–1535.

    Article  CAS  Google Scholar 

  5. Pearson TA et al. AHA Scientific Statement. AHA Guidelines for Primary Prevention of Cardiovascular Disease and Stroke: Update 2002. Consensus panel guide to comprehensive risk reduction for adult patients without coronary or other atherosclerotic vascular diseases. Circulation 2002; 106: 388–391.

    Article  Google Scholar 

  6. Committee on Diet and Health, Chapter 20: Hypertension. In: Diet and Health. Edition National Academy Press: Washington, DC, 1989 pp 529–543.

  7. AFSSA. Apports Nutritionnels Conseillés (ANC). In: Martin A (ed). Apports Nutritionnels Conseillés pour la population française, 3rd edn. Tech. & Doc, Lavoisier: France, 2001.

  8. Lemarchal P et al. Apports nutritionnels conseillés en acides gras essentiels. In: Dupin H, Abraham J, Giachetti I Apports Nutritionnels Conseillés pour la Population Française. 2nd edn. Lavoisier: Paris (France), 1992 pp 74–84.

    Google Scholar 

  9. Grynberg A . Acides gras polyinsaturés, phospholipides et fonctions membranaires. In: Leverve X, Cosnes J, Erny P et Hasselman M (eds). Traité de Nutrition Artificielle de l’Adulte. 2nd édn. Mariette Guena: Paris, 2001.

    Google Scholar 

  10. Liautaud S, Grynberg A, Mourot J, Athias P . Fatty acids of hearts from rats fed linseed or sunflower oil and of cultured cardiomyocytes grown on their sera. Cardioscience 1991; 2 (1): 55–61.

    CAS  PubMed  Google Scholar 

  11. Tamaya-Mori N, Uemura K, Iguchi A . Gender differences in the dietary lard-induced increase in blood pressure in rats. Hypertension 2002; 39: 1015–1020.

    Article  CAS  Google Scholar 

  12. Khan IY et al. Gender-linked hypertension in offspring of lard-fed pregnant rats. Hypertension 2003; 41 (1): 168–175.

    Article  CAS  Google Scholar 

  13. Gerber RT et al. Cholesterol-independent endothelial dysfunction in virgin and pregnant rats fed a diet high in saturated fat. J Physiol 1999; 517: 607–616.

    Article  CAS  Google Scholar 

  14. Zheng ZJ et al. Plasma fatty acid composition and 6-year incidence of hypertension in middle-aged adults: the Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 1999; 150: 492–500.

    Article  CAS  Google Scholar 

  15. Kimura N, Keys A . Coronary heart disease in seven countries. X. Rural Southern Japan. Circulation 1970; 41 (4 Suppl): I101–I112.

    CAS  PubMed  Google Scholar 

  16. Kushi LH et al. Diet and 20-year mortality from coronary heart disease. The Ireland-Boston Diet-Heart Study. N Engl J Med 1985; 312 (13): 811–818.

    Article  CAS  Google Scholar 

  17. de Lorgeril M et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999; 99 (6): 779–785.

    Article  CAS  Google Scholar 

  18. Hu FB et al. Dietary fat intake and the risk of coronary heart disease in women. N Engl J Med 1997; 337 (21): 1491–1499.

    Article  CAS  Google Scholar 

  19. Chiang MT et al. Effect of trans fatty acids on plasma lipids, platelet function and systolic blood pressure in stroke-prone spontaneously hypertensive rats. Lipids 1991; 26: 46–52.

    Article  CAS  Google Scholar 

  20. van de Vijver LP et al. Trans unsaturated fatty acids in plasma phospholipids and coronary heart disease: a case control study. Atherosclerosis 1996; 126: 155–161.

    Article  CAS  Google Scholar 

  21. van de Vijver LP et al. Association between trans fatty acid intake and cardiovascular risk factors in Europe: the TRANSFAIR study. Eur J Clin Nutr 2000; 54: 126–135.

    Article  CAS  Google Scholar 

  22. Burr ML et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989; II: 757–761.

    Article  Google Scholar 

  23. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999; 354: 447–455.

  24. Singh RB et al. Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial. Lancet 2002; 360: 1455–1461.

    Article  Google Scholar 

  25. Forsyth JS et al. Long chain polyunsaturated fatty acid supplementation in infant formula and blood pressure in later childhood: follow up of a randomised controlled trial. Br Med J 2003; 326: 953.

    Article  CAS  Google Scholar 

  26. Rousseau D et al. Is a dietary n-3 fatty acid supplement able to influence the cardiac effect of the psychological stress? Mol Cell Biochem 1998; 178: 353–366.

    Article  CAS  Google Scholar 

  27. Howe PR, Rogers PF, Lungershausen Y . Blood pressure reduction by fish oil in adult rats with established hypertension-dependence on sodium intake. Prostaglandins Leukot Essent Fatty Acids 1991; 44: 113–117.

    Article  CAS  Google Scholar 

  28. Rousseau D et al. Dietary n-3 polyunsaturated fatty acids affect the development of renovascular hypertension in rats. Mol Cell Biochem 2001; 225 (1): 109–119.

    Article  CAS  Google Scholar 

  29. Rousseau D et al. Dietary n-3 PUFAs affect the blood pressure rise and cardiac function modulation in a hyperinsulinemia rat model in vivo. Am J Physiol 2003; 285: H1294–H1302.

    Article  CAS  Google Scholar 

  30. Bonaa KH et al. Effect of eicosapentaenoic and docosahexaenoic acids on blood pressure in hypertension. A population-based intervention trial from the Tromso study. N Engl J Med 1990; 322: 795–801.

    Article  CAS  Google Scholar 

  31. Morris MC, Sacks F, Rosner B . Does fish oil lower blood pressure? A meta-analysis of controled trials. Circulation 1993; 88: 523–533.

    Article  CAS  Google Scholar 

  32. Vericel E, Calzada C, Chapuy P, Lagarde M . The influence of low intake of n-3 fatty acids on platelets in elderly people. Atherosclerosis 1999; 147 (1): 187–192.

    Article  CAS  Google Scholar 

  33. Iacono JM, Dougherty RM . Effects of polyunsaturated fats on blood pressure. Annu Rev Nutr 1993; 13: 243–260.

    Article  CAS  Google Scholar 

  34. Howe PR . Dietary fats and hypertension. Focus on fish oil. Ann NY Acad Sci 1997; 827: 339–352.

    Article  CAS  Google Scholar 

  35. Kenny D, Egan BM . Is there a role for dietary fish oil in the treatment of hypertension? J Hum Hypertens 1994; 8: 895–905.

    CAS  PubMed  Google Scholar 

  36. Gray DR, Gozzip CG, Eastham JH, Kashyap ML . Fish oil as an adjuvant in the treatment of hypertension. Pharmacotherapy 1996; 16: 295–300.

    CAS  PubMed  Google Scholar 

  37. Schmidt EB, Dyerberg J . N-3 fatty acids. Current status in cardiovascular medicine. Drugs 1994; 47: 405–424.

    Article  CAS  Google Scholar 

  38. Kinsella JE, Lokesh B, Stone RA . Dietary n-3 polyunsaturated fatty acids and amelioration of cardiovascular disease: possible mechanisms. Am J Clin Nutr 1990; 52: 1–28.

    Article  CAS  Google Scholar 

  39. Delerive P et al. Hypoxia-reoxygenation and polyunsaturated fatty acids modulate adrenergic functions in cultured cardiomyocytes. J Mol Cell Cardiol 1999; 31: 377–386.

    Article  CAS  Google Scholar 

  40. Mori TA et al. Docosahexaenoic acid but not eicosapentaenoic acid lowers ambulatory blood pressure and heart rate in humans. Hypertension 1999; 34: 253–260.

    Article  CAS  Google Scholar 

  41. Rousseau D . Prévention par les acides gras alimentaires des conséquences cardiaques d’une augmentation de la pression sanguine. PhD thesis. University of Burgundy: France, 2001.

  42. Singer P . Blood pressure-lowering effect of n-3 polyunsaturated fatty acids in clinical studies. World Rev Nutr Diet 1991; 66: 329–348.

    Article  CAS  Google Scholar 

  43. Dallongeville J et al. Fish consumption is associated with lower heart rates. Circulation 2003; 108: 820–825.

    Article  Google Scholar 

  44. Burdge G . Alpha-linolenic acid metabolism in men and women: nutritional and biological implications. Curr Opin Clin Nutr Metab Care 2004; 7 (2): 137–144.

    Article  CAS  Google Scholar 

  45. Wendland E et al. Effect of alpha-linolenic acid on cardiovascular risks markers: a systematic review. 2005; [Epub ahead of print].

  46. Schmitt B et al. Effects of introducing linseed in livestock diet on blood fatty acid composition of consumeers of animal product. Ann Nutr Metab 2002; 46: 182–191.

    Article  Google Scholar 

Download references

Acknowledgements

This work was commissioned by the Factors Affecting Hypertension Task Force of the European branch of the International Life Sciences Institute (ILSI Europe). At the time of the workshop, industry members of this task force were Frito Lay, Kellog, RHM Technology, Unilever and Valio. Further information about ILSI Europe can be obtained through info@ilsieurope.be or tel. +32 (0) 2 771 0014.

Author information

Authors and Affiliations

  1. INRA-Paris 11 UMR1154, Nutrition Lipidique et Régulation Fonctionnelle du Cœur et des Vaisseaux, Faculté de Pharmacie, Châtenay-Malabry, France

    A Grynberg

Authors
  1. A Grynberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A Grynberg.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Grynberg, A. Hypertension prevention: from nutrients to (fortified) foods to dietary patterns. Focus on fatty acids. J Hum Hypertens 19 (Suppl 3), S25–S33 (2005). https://doi.org/10.1038/sj.jhh.1001957

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1001957

Keywords

This article is cited by

Search

Advanced search

Quick links