The two most common diseases of the cerebrovascular and coronary heart cause more than 38% and 42% deaths, respectively [18]. Numerous risk factors are linked to the progress of CVD, including diabetes, dyslipidemia, hypertension, obesity, and smoking [92], and oxidative stress. Imbalance of antioxidants (e.g., glutathione) with pro-oxidants reactive oxygen species leads to the development of oxidative stress in our body. Main CVD-related disorders are atherosclerotic, hypertensive diseases, ischemic heart disease, and stroke along with heart failure [11, 187].

Women with diabetes consuming fish and omega-3 FAs in higher quantities were at a significantly lower rate of CHD incidence. Women consuming fish had a risk factor of CHD of 0.70 for 5 times per week significantly lowered the incidence of CHD in diabetic women [56].

The plasma lipid modulatory effect was showed by EPA and DHA in CVD and diabetic women [93]. Omega-3 FAs lowered the triglyceride level by decreasing the VLDL assembly and secretion. The reduced activity of sterol receptor element-binding protein-lc by co-3 FAs leads to inhibition of lipogenesis. By activating the peroxisome PPAR-a and co-3 FAs favor the p-oxidation in mitochondria and peroxisomes; and also reduces the fatty acid substrate for triglyceride synthesis [33].

The mam cause of all CVD issues (claudication, heart failure, myocardial infarction, and stroke) is the atherosclerosis. Atherosclerosis mostly occurred in the innermost layers of middle and large sized arteries, mainly where vessels become separated [16]. Atherosclerosis disease develops in a long-time period; therefore, former lipid management can prevent the atherosclerotic vascular diseases [134].

In the prevention of CVD, the focus is to decrease low-density lipoprotein-cholesterol. It is assessed that every 1% decrease in LDL-cholesterol results in 1% to 2% reduction of CVD risks [39]. Even though in overall risk determination, a considerable percentage of CVD issues occur due to series of genetic factors and aging, which can be regulated, and these modifiable factors include lifestyle factors, such as diet and physical exercise, hyperlipidemia, hypertension, obesity, diabetes, and insulin resistance [23].


Several data are available highlighting the ability of omega-3 PUFAs to affect arrhythmia [66], endothelial function [100], inflammation, and blood pressure, lipid profile [133], and platelet activity [80, 154] as shown Figure 6.1. Risk factors affecting CVDs are levels of [154]:

Effects of omega-3 PUFAs and peptides on cardiovascular risk factors

FIGURE 6.1 Effects of omega-3 PUFAs and peptides on cardiovascular risk factors.

  • • HDL-C (high density lipoprotein-cholesterol);
  • • LDL-C (low density lipoprotein-cholesterol);
  • • 0-3 PUFAs (omega-3 polyunsaturated FAs);
  • • TC (total cholesterol);
  • • TG (triglycerides).


Ventricular arrhythmias are associated with muscle contraction controlling electrophysiological mechanisms [129]. Data from animal and in vitro studies exhibited that n-3 PUFAs influence cardiac ionic channels [80]. The n-3 PUFAs have noticeable preventive influences on sodium, potassium, sodium-calcium exchanger, and L-type calcium channels thus lower excitability based on data obtained from cardiomyocytes [84].

Furthermore, n-3 PUFAs may change the fluidity of membrane that in turn can affect ionic transport [76]. Reduction in ischemia-induced ventricular fibrillation in dogs and pigs are done by treating them with n-3 PUFAs through action on potassium channels [164]. An action of n-3 PUFAs on autonomic control may mediate its anti-arrhythmic effects, especially through an enhanced vagal tone [24]. Overall all, these mechanisms are constantly linked with anti-arrhythmic reactions and reduced levels of abrupt cardiac deaths detected in some human studies [77]. Table 6.7 indicates organizations recommending fish consumption for human health benefits.

TABLE 6.7 Different Organizations Recommending Fish Consumption for Human Health Benefits






Scientific Advisory Committee for Nutrition (SACN)

450 mg DHA + EPA daily




International Society for the Study of Fatty Acids and Lipids (ISSFAL)

500 mg DHA + EPA daily




European Food Safety Association (EFSA)

250 mg DHA + EPA daily




World Health Organization (WHO)/ Food and Agricultural Organization of the United Nations (FAO)

At least 1-2 100 g sewings of fatty' fish per week

World wide



The Norwegian Directorate of Health/ 5'KM

Must eat fish 2-3 times per week in dinner




The American Heart Association

Eat fish two tunes hi a week





Different research studies on nonnotensive and hypertensive subjects have specified that the blood pressure is lowered by taking a high dose of n-3 PUFAs, though this influence was more distinct in hypertensive subjects [101]. Minihane et al. [94] have revealed that ingesting of 2-3 servings of oily fish per week or 2 capsules of fish oil per day to provide EPA + DHA was able to decrease the systolic blood pressure by 5 nunHg in systolic hypertensive subjects [94, 138] due to (i) the capability of n-3 PUFAs to reduce the synthesis of thromboxane A2; (ii) to increase the production of nitric oxide; and (iii) to influence the autonomic nerve function.

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