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REGIONAL DIFFERENCES IN HYPERTENSIVE CARDIOVASCULAR REMODELING BETWEEN FISHING AND FARMING COMMUNITIES IN JAPAN: 7C.03

Objectives: Effects of dietary n-3 polyunsaturated fatty acids intake on cardiovascular system have been reported. Our aim was to examine differences in hypertensive cardiovascular remodeling between fishing and farming communities in Japan, and to find any strategies to minimize these differences. Design: Cross-sectional study. Methods: We recruited 263 essential hypertensive patients from a fishing village and 333 from a farming village; all subjects were >40 years (mean age, 73 years; 42%men). They were cross-sectionally examined for serum eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) levels, left ventricular mass index (LVMI), and common-carotid and internal-carotid artery (CCA, ICA) intima-media thickness (IMT). Results: Patients in the fishing village had higher serum EPA level (70.9 vs. 63.2 μg/ml) and DHA level (157.8 vs. 137.2 μg/ml) than those in the farming village, while patients in the fishing village were more centrally obese and had unfavorable glucose and lipid metabolic profiles. Both LVMI and the extent of CCA-IMT and ICA-IMT levels were significantly lower in the fishing village than the farming village (113.2 vs.121.6 g/m2, 0.88 vs.0.94 mm, 1.10 vs.1.17 mm, respectively; all P < 0.01) even after adjustment for significant covariates. The differences, however, were observed only in patients with poor-controlled 24-hour blood pressure (BP) levels (>130/80mmHg, n = 367: 117.7 vs.129.2 g/m2, 0.90 vs.0.96 mm, 1.11 vs.1.20 mm, respectively; all P < 0.05), but not in those with well-controlled 24-hour BP levels (<130/80mmHg: 107.0 vs.109.3 g/m2, 0.85 vs.0.90 mm, 1.10 vs.1.13 mm, respectively; all P = NS). Although such regional differences remained significant even after adjustment for serum EPA and DHA levels, serum DHA level was an independent determinant of LVMI, especially in patients with poor-controlled 24-hour BP levels (β = −0.137, P = 0.003). Conclusion: Cardiovascular remodeling was significantly lower in fishing than farming communities in Japanese hypertensive patients; the difference, however, was nonsignificant in patients with well-controlled 24-hour BP levels. Serum DHA level was an independent negative determinant of cardiac hypertrophy, especially under high BP condition.