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FISH OIL DRUG MAY HELP PREVENT, TREAT RISK FACTORS FOR CORONARY DISEASE - ESPECIALLY IN WOMEN AND THOSE WITH DIABETES

FISH OIL DRUG MAY HELP PREVENT, TREAT RISK FACTORS FOR CORONARY DISEASE
 - ESPECIALLY IN WOMEN AND THOSE WITH DIABETES
 OSLO, Norway, Sept. 15 /PRNewswire/ -- High concentrations of certain fish oils may reduce several risk factors of coronary disease -- especially in postmenopausal women and individuals with diabetes -- scientists from around the world told researchers meeting here today.
 "Papers presented at this symposium have documented that a drug composed of omega-3 fatty acids, found in fatty fish, may be of special significance for the factors involved in a new coronary risk profile called 'metabolic' or 'thrombo-atherogenic' syndrome," explains symposium moderator Professor Arne Nordoy, from the Department of Medicine, University Hospital of Tromso, Norway.
 Dietary saturated fats, hypertension, smoking and high serum cholesterol levels have been accepted as important non-genetic risk factors in the development of coronary heart disease, Dr. Nordoy said.
 "However, during the last few years, the thrombo-atherogenic syndrome has been established as a separate high risk syndrome for development of coronary heart disease," Nordoy told the symposium attendees.
 "This syndrome includes obesity with increased waist/hip ratio, insulin resistance, hypertension, high triglyceride levels and low high density lipoprotein (HDL) concentrations. High concentrations of omega-3 fatty acids significantly impact several components of the thrombo-atherogenic syndrome."
 Scientists presenting to the Oslo symposium included:
 -- John C. Hoak, MD, Director, Division of Blood Diseases and
 Resources, National Heart, Lung and Blood Institute, National
 Institutes of Health, Bethesda, MD
 -- Dr. Kare Bonaa, Institute for Samfunnsmedisin, University of
 Tromso, Norway
 -- Dr. Erik Berg Schmidt, Department of Medicine, Aalborg Hospital,
 Denmark
 -- Dr. Ingvar Hjermann, Medisinsk avdeling, Oslo, Norway
 -- Professor Gaetano Crepaldi, Department of Internal Medicine,
 University of Padova, Italy
 -- Professor Eva Swahn, Department of Internal Medicine, Faculty of
 Health Sciences, Lindkoping, Sweden
 -- Professor Harald Arnesen, Medisinsk avdeling, Ulleval Hospital,
 Oslo, Norway
 The symposium was sponsored by Pronava a/s, a Norwegian company developing high-concentration omega-3 drugs for ethical (prescription) and OTC use. Pronova supplies an 85 percent concentration of EPA and DHA to SPA - Societa Prodotti Antibiotici S.p.A., one of Italy's leading pharmaceutical companies. SPA markets the product as Seacor, a prescription drug indicated for primary treatment of hypertriglyceridemia. In 1993, Pronova expects to submit its drug, K85, for registration in the European Community.
 Thrombo-atherogenic syndrome, omega-3 fatty acids...and women:
 As implied in the recently suggested new name of the syndrome, the risk factors seem to be related both to thrombogenesis (the formation of blood clots) and to atherosclerosis (deposition of fats in the arteries.)
 Studies presented at the conference showed that an 85 percent concentration of the principal omega-3 fatty acids in certain fish oils -- EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) -- significantly reduced factors associated with both clot formation and atherosclerosis. Additional long-term studies will be necessary to determine whether these effects translate into reduced risk of heart attack and stroke.
 According to Professor Nordoy, omega-3 fatty acids may have special value in protecting postmenopausal women from the thrombo-atherogenic syndrome.
 "Women seem to be protected against coronary heart disease compared with men," Nordoy said.
 "However, in the years following the menopause, the incidence of coronary heart disease in women increases. Recent surveys among postmenopausal women have routinely identified a cluster of risk factors included in this syndrome. The thrombotic events have been related to a stimulated coagulation system and an inhibitory effect on the fibrinolytic system. Therefore, the benefits of preventative or therapeutic application of 85 percent omega-3 products might be seen first in this group of patients."
 Omega-3 therapy: Special potential in diabetes:
 While scientists presenting papers at the Oslo symposium reported improvement in risk factors in a wide range of individuals treated with high-concentration omega-3 fatty acids, Professor Gaetano Crepaldi of the University of Padova, Italy believes this therapy holds special importance for individuals with the common "Type II" (typically non- insulin-dependent) form of diabetes. Italy is the only country in which high-concentration omega-3 drugs are currently approved for routine clinical use.
 "In diabetics the risk of atherosclerotic vascular complications is related to the classic cardiovascular risk factors -- elevated blood lipids, hypertension and cigarette smoking," Dr. Crepaldi said.
 "The most recent data from the Paris Prospective Study show that only elevated triglycerides consistently predict whether a specific individual with Type II diabetes will develop heart disease," Dr. Crepaldi noted. Therefore, preventive therapy with high-concentration omega-3 therapy may be of special benefit in these individuals.
 "In non-insulin-dependent diabetes, microalbuminuria (presence of protein in the urine) is an important predictor of all-cause mortality, in particular cardiovascular mortality," Dr. Crepaldi told the Oslo symposium attendees.
 "Our studies show that microalbuminuria, hypertension, and peripheral insulin resistance are associated with higher triglyceride levels, smaller LDL (low-density lipoprotein) particles, and lower high- density lipoprotein (HDL) levels...particularly HDL-2, the so-called 'good cholesterol' levels.
 "By treating such patients with high-concentration omega-3 fatty acids, we should be able to modify several vascular risk factors -- in particular, blood pressure and plasma lipids," Dr. Crepaldi said. "However, we need additional research to define the exact effects of omega-3 fatty acids on glucose metabolism."
 Omega-3 Fatty Acids: Many Western Diets Are Deficient:
 EPA and DHA, the specific fatty acids believed by investigators to reduce the propensity of treated patients to form blood clots and obstructive lipid deposits, are very long-chain omega-3 fatty acids (20 and 22 carbons). Most circulating EPA and DHA comes from the ingestion of foods containing these fatty acids, because the human body cannot synthesize them.
 EPA and DHA are synthesized in phytoplankton and are the source of omega-3 fatty acids for marine animals. Fatty fish such as salmon, mackerel, herring and sardines are particularly rich in these fatty acids (see attached table).
 OMEGA-3 FATTY ACIDS, SATURATED FATS PER 100 g OF FISH OIL (A)
 Total Fat Total Saturated EPA (g) DHA (g) Cholesterol
 (grams) Fat (grams) (mg)
 Cod (Pacific) 0.6 0.1 0.1 0.1 61
 Mackerel
 (Atlantic) 14.0 3.6 0.9 1.6 80
 Salmon
 (Chinook) 10 2.5 0.8 0.6 74
 Cod liver
 oil 100 17.6 9.0 9.6 570
 To protect against the thrombo-atherogenic syndrome, scientists theorize that the average adult would have to ingest 2 to 3 grams of EPA and DHA daily. Unfortunately, the only species containing significant omega-3 oils are considered "too fishy" by many Westerners...and even the oil in those fish is significantly oxidized to useless compounds when these fish are cooked.
 Ordinary Fish Oils, Low-Concentration "EPA" Supplements: Limited
 Value:
 For more than 100 years, cod liver oil has been promoted for general medicinal value, and for almost a decade, health enthusiasts have claimed even more remarkable benefits for over-the-counter "EPA" fish oil capsules. However, most of these oils and capsules contain about 30 percent saturated fats, including as much as 600 mg of cholesterol per gram in the most popular brand. These high saturated fat levels, and low omega-3 levels might explain why certain scientific studies have failed to confirm much benefit for such supplements.
 By comparison, Pronova's drug studied by researchers reporting at the Oslo conference contains more than 90 percent omega-3 fatty acids -- 85 percent EPA and DHA alone.
 (A) Adapted from Davidson, M.H. et al, "Marine Oil Capsule Therapy for the Treatment of Hyperlipidemia"; "Arch Int Med," 1991:151, 1732- 1740.
 -0- 9/15/92
 /CONTACT: Cecilie Gunderson of Burson Marsteller (in Oslo) 47-2-12-03-90, or Charles Braver of ProClinica, 212-856-6440/ CO: ST: IN: MTC SU:


LD -- NY077 -- 9886 09/15/92 20:00 EDT
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