Effect of omega-3 fatty acids on heart rate variability in depressed patients with coronary heart disease

• Published in: Psychosomatic medicine 2010-10, Vol.72 (8), p.748-754
• Main Authors: Carney, Robert M, Freedland, Kenneth E, Stein, Phyllis K, Steinmeyer, Brian C, Harris, William S, Rubin, Eugene H, Krone, Ronald J, Rich, Michael W
• Format: Article
• Language: English
• Subjects: Cardiovascular disease; Circadian Rhythm - drug effects; Comorbidity; Coronary Disease - diagnosis; Coronary Disease - drug therapy; Coronary Disease - epidemiology; Depression; Depressive Disorder - diagnosis; Depressive Disorder - epidemiology; Drug Therapy, Combination; Electrocardiography, Ambulatory - drug effects; Electrocardiography, Ambulatory - statistics & numerical data; Fatty acids; Fatty Acids, Omega-3 - pharmacology; Fatty Acids, Omega-3 - therapeutic use; Female; Heart diseases; Heart rate; Heart Rate - drug effects; Humans; Male; Mental depression; Middle Aged; Mortality; Myocardial Infarction - diagnosis; Myocardial Infarction - drug therapy; Placebo effect; Placebos; Sertraline; Sertraline - therapeutic use; Treatment Outcome; Variability
• ISSN: 0033-3174; 1534-7796
• DOI: 10.1097/PSY.0b013e3181eff148

To determine whether omega-3 fatty acid (FA) increases the natural log of very low frequency (lnVLF) power, an index of heart rate variability (HRV), and reduces 24-hour heart rate (HR) in depressed patients with coronary heart disease (CHD). Low intake of omega-3 FAs is associated with depression and with low HRV, and all three are associated with an increased risk of death in patients with CHD. Thirty-six depressed patients with CHD randomized to receive 50 mg of sertraline and 2 g of omega-3/day, and 36 randomized to sertraline and a placebo, had 24-hour HRV measured at baseline and after 10 weeks of treatment. There was a significant treatment × time interaction for covariate adjusted lnVLF (p = .009), for mean 24-hour HR (p = .03), and for 1-minute resting HR (p = .02). The interaction was not significant for three other measures of HRV. LnVLF did not change over time in the omega-3 arm but decreased in the placebo arm (p = .002), suggesting that omega-3 may have prevented or slowed deterioration in cardiac autonomic function. The effects of omega-3 FAs on lnVLF and HR, although modest, were detected after only 10 weeks of treatment with 2 g per day of omega-3. Whether a longer course of treatment or a higher dose of omega-3 would further decrease HR, improve other indices of HRV, or reduce mortality in depressed CHD patients should be investigated.