The Eicosapentaenoic Acid:arachidonic Acid Ratio and Its Clinical Utility in Cardiovascular Disease.

Nelson John R., Raskin S.
Postgraduate medicine, 2019

Abstract

Eicosapentaenoic acid (EPA) is a key anti-inflammatory/anti-aggregatory long-chain polyunsaturated omega-3 fatty acid. Conversely, the omega-6 fatty acid, arachidonic acid (AA) is a precursor to a number of pro-inflammatory/pro-aggregatory mediators. EPA acts competitively with AA for the key cyclooxygenase and lipoxygenase enzymes to form less inflammatory products. As a result, the EPA:AA ratio may be a marker of chronic inflammation, with a lower ratio corresponding to higher levels of inflammation. It is now well established that inflammation plays an important role in cardiovascular disease. This review examines the role of the EPA:AA ratio as a marker of cardiovascular disease and the relationship between changes in the ratio (mediated by EPA intake) and changes in cardiovascular risk. Epidemiological studies have shown that a lower EPA:AA ratio is associated with an increased risk of coronary artery disease, acute coronary syndrome, myocardial infarction, stroke, chronic heart failure, peripheral artery disease, and vascular disease. Increasing the EPA:AA ratio through treatment with purified EPA has been shown in clinical studies to be effective in primary and secondary prevention of coronary artery disease and reduces the risk of cardiovascular events following percutaneous coronary intervention. The EPA:AA ratio is a valuable predictor of cardiovascular risk. Results from ongoing clinical trials will help to define thresholds for EPA treatment associated with better clinical outcomes.

Keywords

Eicosapentaenoic acid; arachidonic acid; cardiovascular disease; coronary artery disease; inflammation; long-chain polyunsaturated omega-3 fatty acids; omega 3 fatty acids.

The best supplements with Eicosapentaenoic Acid in Cardiovascular Support category:

• Organic Flax Seed Oil, 1,000 mg, 90 Softgels (Zahler) - Cold Pressed Flaxseed OilZehaler Flaxseed Oil is high in alpha-linolenic acid (ALA), which is partially converted by the body into other important nutrients like DHA and EPA, Cold pressed from organic flax seeds, Zahler's Flaxseed Oil is 100% pure and natural, unmodified by chemical refinements. It contains among others: Eicosapentaenoic Acid.
• Liquid Omega-3, Deep Sea Fish Oil EPA/DHA, Natural Orange Flavor, 16 fl oz (480 ml) (Nature's Answer) -

  Omega-3 Fish Oil provides, molecularly distilled, nitrogen flushed fish body oil, harvested in the cold, clean waters of the North Atlantic. It contains among others: Eicosapentaenoic Acid.

• Liquid Norwegian Cod Liver Oil, Natural Lemon-Lime Flavor, 16 fl oz (480 ml) (Nature's Answer) - Nature’s Answer Liquid Cod Liver Oil is harvested from the deep, clean, cold waters of the North Atlantic. It contains among others: Eicosapentaenoic Acid.
• Marine Algae Derived Vegan Omega-3, 120 Softgels (Zenwise Health) - M It contains among others: Eicosapentaenoic Acid.
• Omega-3 Fish Oil, Ultra-Pure Cold-Water Fish Oil, 180 Softgels (ALLMAX Nutrition) - Athletes have long known the power of Deep Cold-Water fish oil to attain peak physical performance. It contains among others: Eicosapentaenoic Acid.
• Fish Oil, 1,000 mg, 300 Softgels (21st Century) - EPA and DHA are important Omega-3 fatty acids that supports cardiovascular health as well as being important components of the cells in the body. It contains among others: Eicosapentaenoic Acid.
• Omega 3-6-9, 1,300 mg, 120 Softgels (Solgar) - This formula provides a blend of three premium oils - Fish, Flax and Borage. It contains among others: Eicosapentaenoic Acid.
• Omega-3, EPA & DHA, Triple Strength, 950 mg, 50 Softgels (Solgar) - Omega 3 950 mg is Solgar's highest concentration of the natural Omega 3 polyunsaturates EPA and DHA from cold-water fish. It contains among others: Eicosapentaenoic Acid.
• Omega-3, EPA & DHA, Triple Strength, 950 mg, 100 Softgels (Solgar) - Omega 3 950 mg is Solgar’s highest concentration of the natural Omega 3 polyunsaturates EPA and DHA from cold-water fish. It contains among others: Eicosapentaenoic Acid.
• Tri-3D Omega, 330 EPA/220 DHA, 90 Softgels (Now Foods) - The natural fish oil concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• Omega-3, 180 Softgels (Now Foods) - The natural fish oil concentrate is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• Neptune Krill Oil, 500 mg, 120 Softgels (Now Foods) - NKO (Neptune Krill Oil) (Euphausia Superba) is known for its unique fatty acid (FA) profile, which includes EPA and DHA, plus phospholipids. It contains among others: Eicosapentaenoic Acid.
• High Lignan Flax Oil, 1,000 mg, 120 Softgels (Now Foods) - Flax Oil (Linum Usitatissimum) is a natural reservoir for the omega-3 fatty acid, Alpha-Linolenic Acid (ALA). It contains among others: Eicosapentaenoic Acid.
• Omega-3, Molecularly Distilled, 30 Softgels (Now Foods) - This natural fish oil concentrate is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• Omega-3 Mini Gels, 180 Softgels (Now Foods) - The Natural Fish Oil concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• Super Omega EPA, Molecularly Distilled, 240 Softgels (Now Foods) - NOW Super Omega EPA has twice the EPA (360 mg per softgel) as in our regular strength product (180 mg per softgel). It contains among others: Eicosapentaenoic Acid.
• DHA-500/EPA-250, Double Strength, 180 Softgels (Now Foods) - NOW DHA-500 has twice the DHA (500 mg per softgel) as in our regular strength product (250 mg per softgel). It contains among others: Eicosapentaenoic Acid.
• Omega 3-6-9, 1000 mg, 250 Softgels (Now Foods) - Omega 3-6-9 is a blend of Flax-Seed (Linum Usitatissimum), Evening Primrose (Oenothera Biennis), Canola (Brassica Napus) / Omega-9 / Erucic Acid , Black Currant Seed Oils (Ribes Nigrum) - which contains: EPA, DHA, ALA, GLA and Linoleic Acid; and Pumpkin Seed Oils (Cucurbita Pepo). It contains among others: Eicosapentaenoic Acid.
• Super Omega 3-6-9, 1200 mg, 180 Softgels (Now Foods) - Super Omega 3-6-9 is a blend of Fish, Borage and Flax Seed Oils (Linum Usitatissimum). It contains among others: Eicosapentaenoic Acid.
• Ultra Omega 3-D, 600 EPA/300 DHA, 180 Softgels (Now Foods) - Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease. It contains among others: Eicosapentaenoic Acid.
• Ultra Omega-3, 500 EPA/250 DHA, 90 Softgels (Now Foods) - Supportive but not conclusive research shows that consumption of EPA and DHA omega-3 fatty acids may reduce the risk of coronary heart disease. It contains among others: Eicosapentaenoic Acid.
• Omega-3, 180 EPA/120 DHA, 500 Softgels (Now Foods) - The natural fish oil concentrate used in this softgel in manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• Omega-3, 180 EPA/120 DHA, 200 Softgels (Now Foods) - The natural fish oil concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• Ultra Omega-3, 500 EPA/250 DHA, 180 Softgels (Now Foods) - The Natural Fish Oil Concentrate used in this softgel is manufactured under strict quality control standards. It contains among others: Eicosapentaenoic Acid.
• Kid's Chewable DHA, Fruit Flavor, 60 Softgels (Now Foods) - K It contains among others: Eicosapentaenoic Acid.
• Vitabase - Enfūz (Advanced) - Enfūz Advanced is a complete nutritional supplement program designed to meet your basic nutritional needs. It contains among others: Eicosapentaenoic Acid.

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