Background—Hyperlipidemia is associated with endothelial dysfunction, an early event in atheroscl... more Background—Hyperlipidemia is associated with endothelial dysfunction, an early event in atherosclerosis and predictor of risk for future coronary artery disease. Epidemiological studies suggest that increased dietary intake of antioxidants reduces the risk of coronary artery disease. The purpose of this study was to determine whether antioxidant vitamin therapy improves endothelial function and affects surrogate biomarkers for oxidative stress and inflammation in hyperlipidemic children. Methods and Results—In a randomized, double-blind, placebo-controlled trial, the effects of antioxidant vitamins C (500 mg/d) and E (400 IU/d) for 6 weeks and the National Cholesterol Education Program Step II (NCEP-II) diet for 6 months on endothelium-dependent flow-mediated dilation (FMD) of the brachial artery were examined in 15 children with familial hypercholesterolemia (FH) or the phenotype of familial combined hyperlipidemia (FCH). Antioxidant vitamin therapy improved FMD of the brachial art...
located on the World Wide Web at: The online version of this article, along with updated informat... more located on the World Wide Web at: The online version of this article, along with updated information and services, is
Hypertension is a major risk factor for cardiovascular disease which increases with aging. Dietar... more Hypertension is a major risk factor for cardiovascular disease which increases with aging. Dietary and lifestyle interventions have been recommended to optimize blood pressure levels. Dietary omega-3 fatty acids, eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), have an important role in cardiovascular health and disease. Convincing experimental and clinical evidence suggests that EPA and DHA provide vascular protection by improving endothelial function and lowering blood pressure. Potential mechanisms for these effects include fatty acid uptake and incorporation into endothelial cell membranes which modulate multiple important cell functions. The present review also addresses the vascular physiology, endothelial function and pathophysiology of hypertension, the potential mechanisms and metabolism of omega-3 fatty acids. In addition, guidelines for dietary intake of omega-3 fatty acids and measurement of omega-3 fatty acid intake are presented.
We have previously demonstrated the vasorelaxant properties of the omega-3 fatty acid, eicosapent... more We have previously demonstrated the vasorelaxant properties of the omega-3 fatty acid, eicosapentaenoic acid (EPA), in normotensive and spontaneously hypertensive rat (SHR) aorta, although the mechanism(s) of action are not fully understood. Because endothelial dysfunction and increased intracellular free calcium concentration ([Ca2+]i) are seen in hypertensive rat aorta, we investigated the potential role of Ca2+ signaling, endothelium and derived factors, and the opening of potassium (K+) channels in EPA-induced relaxation. In the presence of extracellular Ca2+, EPA induced significant relaxations at >10 micromol/L (P<.01) in norepinephrine (NE) (10(-6) mol/L)-contracted aortic rings and at 30 micromol/L (P<.001) in high K+ (80 mmol/L)-contracted aortic rings. In the absence of extracellular Ca2+, EPA (10 to 30 micromol/L) inhibits the tonic component of NE-induced contraction (P<.0001). The relaxant properties of EPA in SHR aorta appear specific to Ca2+ release from a...
The stress response increases sympathetic nervous activity, which can adversely affect the cardio... more The stress response increases sympathetic nervous activity, which can adversely affect the cardiovascular system. Cardiovascular disease is due in part to stress-induced mechanisms mediated primarily through increased adrenergic stimulation. These stress-induced mechanisms include elevations in serum lipid levels, alterations in blood coagulation, atherogenesis, vascular changes in hypertension, and myocardial ischemia. Stress management interventions for hypertension are controversial; however, interventions for coronary heart disease-prone behavior patterns have proven successful. Stress management interventions have also reduced cardiovascular events, mortality, and coronary atherosclerosis. Assessment of stress includes individual interviews, which can be complemented by information derived from questionnaires and mental stress testing. Educational and relaxation strategies can prepare patients to understand and cope with stress. These approaches will hopefully decrease the occurrence of stress and, ultimately, the risk for cardiovascular disease.
Dietary consumption of omega-3 polyunsaturated fatty acids (PUFAs) found in seafood and fish oils... more Dietary consumption of omega-3 polyunsaturated fatty acids (PUFAs) found in seafood and fish oils is associated with a decrease in coronary heart disease and overall cardiovascular mortality. Omega-3 PUFAs exert a number of physiologic effects, including relaxation of vascular smooth muscle, lowering of blood pressure, interference in phosphatidylinositol signaling, a reduction in platelet aggregation and growth factors, a decrease in atherogenic lipoproteins, a reduction in thrombotic factors, alterations in eicosanoid metabolism, a decrease in platelet and macrophage activating factors, and an increase in thrombolytic substances. These factors may provide a therapeutic means of reducing cardiovascular disease. This article reviews the vascular effects of omega-3 PUFAs and discusses the hypolipidemic, antihypertensive, antiatherosclerotic, antiinflammatory, and antithrombotic actions of the omega-3 PUFAs. Specific nursing implications are addressed.
The authors investigated the vasorelaxant properties of the omega-3 fatty acid, docosahexaenoic (... more The authors investigated the vasorelaxant properties of the omega-3 fatty acid, docosahexaenoic (DHA, 22:6n-3), and the possible involvement of endothelium-derived nitric oxide, prostanoids, opening of K+ channels, and/or modulation of calcium-mediated events. Isolated aorta from male spontaneously hypertensive rats (SHR) (age 16-17 weeks) were used to measure isometric tension. DHA-induced (1-100 mumol/l) relaxation was examined following contraction to norepinephrine (NE) (10(-6) mol/l) or high-K+ (80 mmol/l) solution in the presence and absence of various inhibitors and calcium-containing solution. DHA acid induced a significant vasorelaxant effect in both NE and high-K(+)-induced contracted SHR aortic rings, although DHA relaxations were greater in high-K(+)-induced contracted rings. In the absence of extracellular calcium, DHA (5-30 mumol/l) inhibited the initial phasic and sustained components of NE-induced contraction under different conditions. Inhibition of nitric oxide synthesis by N omega-nitro-L-arginine methyl ester hydrochloride (100 mumol/l) had no effect on DHA relaxations; however, indomethacin or nifedipine caused significant inhibition at &gt; or = 30 mumol/l DHA. The K+ channel blocker, glibenclamide, but not tetraethyl-ammonium, also had an inhibitory effect on DHA-induced relaxation. These results indicate that DHA&#39;s vasorelaxant actions in SHR aorta are independent of endothelium-derived nitric oxide; however, at DHA concentrations &gt; or = 30 mumol/l, vasodilatory prostanoids that activate ATP-sensitive K+ channels (KATP) may be involved. At lower concentrations, DHA-induced relaxation appears to be attributed to modulation of intracellular Ca2+ release and L-type Ca2+ channels in vascular smooth muscle cells. The vasorelaxant properties of DHA may contribute, in part, to the blood pressure-lowering effect of dietary fish oil in this hypertensive model.
This article summarizes the highlights of the 1993 Report of the Joint National Committee on Dete... more This article summarizes the highlights of the 1993 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. These guidelines provide nurses and patients with important information about therapies for hypertension (e.g. lifestyle modification and pharmacologic therapy); treatment for specific populations (e.g. black, young, pregnant, and elderly patients); and, factors which cause hypertension (e.g. cocaine, lithotripsy, cyclosporine, and erythropoietin). This article addresses antihypertensive drugs and provides an algorithm for the treatment of hypertension. The implications for nurses in view of these new guidelines are also presented.
Prostaglandins, leukotrienes, and essential fatty acids, 1993
The effects of oils enriched with gamma-linolenic acid (GLA) on blood pressure and pressor respon... more The effects of oils enriched with gamma-linolenic acid (GLA) on blood pressure and pressor responses were examined in spontaneously hypertensive rats (SHR). Rats were fed purified diets containing evening primrose (EPO), black currant (BCO), borage (BOR) or fungal (FGO) oils for 7 weeks. Significant reductions in blood pressure were obtained in SHR rats maintained on diets enriched with GLA oils. The antihypertensive effect was not associated with enhanced pressor responsiveness to norepinephrine or angiotensin II. Moreover, no differences were found in blood pressure responses to the calcium channel blocker, verapamil. The results suggest that GLA-enriched oils inhibit the development of hypertension in the SHR rat. The blood pressure lowering effect is not mediated by altered pressor responses to vasoconstrictor hormones or intracellular calcium mechanisms.
Background—Hyperlipidemia is associated with endothelial dysfunction, an early event in atheroscl... more Background—Hyperlipidemia is associated with endothelial dysfunction, an early event in atherosclerosis and predictor of risk for future coronary artery disease. Epidemiological studies suggest that increased dietary intake of antioxidants reduces the risk of coronary artery disease. The purpose of this study was to determine whether antioxidant vitamin therapy improves endothelial function and affects surrogate biomarkers for oxidative stress and inflammation in hyperlipidemic children. Methods and Results—In a randomized, double-blind, placebo-controlled trial, the effects of antioxidant vitamins C (500 mg/d) and E (400 IU/d) for 6 weeks and the National Cholesterol Education Program Step II (NCEP-II) diet for 6 months on endothelium-dependent flow-mediated dilation (FMD) of the brachial artery were examined in 15 children with familial hypercholesterolemia (FH) or the phenotype of familial combined hyperlipidemia (FCH). Antioxidant vitamin therapy improved FMD of the brachial art...
located on the World Wide Web at: The online version of this article, along with updated informat... more located on the World Wide Web at: The online version of this article, along with updated information and services, is
Hypertension is a major risk factor for cardiovascular disease which increases with aging. Dietar... more Hypertension is a major risk factor for cardiovascular disease which increases with aging. Dietary and lifestyle interventions have been recommended to optimize blood pressure levels. Dietary omega-3 fatty acids, eicosapentaenoic (EPA) and docosahexaenoic acids (DHA), have an important role in cardiovascular health and disease. Convincing experimental and clinical evidence suggests that EPA and DHA provide vascular protection by improving endothelial function and lowering blood pressure. Potential mechanisms for these effects include fatty acid uptake and incorporation into endothelial cell membranes which modulate multiple important cell functions. The present review also addresses the vascular physiology, endothelial function and pathophysiology of hypertension, the potential mechanisms and metabolism of omega-3 fatty acids. In addition, guidelines for dietary intake of omega-3 fatty acids and measurement of omega-3 fatty acid intake are presented.
We have previously demonstrated the vasorelaxant properties of the omega-3 fatty acid, eicosapent... more We have previously demonstrated the vasorelaxant properties of the omega-3 fatty acid, eicosapentaenoic acid (EPA), in normotensive and spontaneously hypertensive rat (SHR) aorta, although the mechanism(s) of action are not fully understood. Because endothelial dysfunction and increased intracellular free calcium concentration ([Ca2+]i) are seen in hypertensive rat aorta, we investigated the potential role of Ca2+ signaling, endothelium and derived factors, and the opening of potassium (K+) channels in EPA-induced relaxation. In the presence of extracellular Ca2+, EPA induced significant relaxations at >10 micromol/L (P<.01) in norepinephrine (NE) (10(-6) mol/L)-contracted aortic rings and at 30 micromol/L (P<.001) in high K+ (80 mmol/L)-contracted aortic rings. In the absence of extracellular Ca2+, EPA (10 to 30 micromol/L) inhibits the tonic component of NE-induced contraction (P<.0001). The relaxant properties of EPA in SHR aorta appear specific to Ca2+ release from a...
The stress response increases sympathetic nervous activity, which can adversely affect the cardio... more The stress response increases sympathetic nervous activity, which can adversely affect the cardiovascular system. Cardiovascular disease is due in part to stress-induced mechanisms mediated primarily through increased adrenergic stimulation. These stress-induced mechanisms include elevations in serum lipid levels, alterations in blood coagulation, atherogenesis, vascular changes in hypertension, and myocardial ischemia. Stress management interventions for hypertension are controversial; however, interventions for coronary heart disease-prone behavior patterns have proven successful. Stress management interventions have also reduced cardiovascular events, mortality, and coronary atherosclerosis. Assessment of stress includes individual interviews, which can be complemented by information derived from questionnaires and mental stress testing. Educational and relaxation strategies can prepare patients to understand and cope with stress. These approaches will hopefully decrease the occurrence of stress and, ultimately, the risk for cardiovascular disease.
Dietary consumption of omega-3 polyunsaturated fatty acids (PUFAs) found in seafood and fish oils... more Dietary consumption of omega-3 polyunsaturated fatty acids (PUFAs) found in seafood and fish oils is associated with a decrease in coronary heart disease and overall cardiovascular mortality. Omega-3 PUFAs exert a number of physiologic effects, including relaxation of vascular smooth muscle, lowering of blood pressure, interference in phosphatidylinositol signaling, a reduction in platelet aggregation and growth factors, a decrease in atherogenic lipoproteins, a reduction in thrombotic factors, alterations in eicosanoid metabolism, a decrease in platelet and macrophage activating factors, and an increase in thrombolytic substances. These factors may provide a therapeutic means of reducing cardiovascular disease. This article reviews the vascular effects of omega-3 PUFAs and discusses the hypolipidemic, antihypertensive, antiatherosclerotic, antiinflammatory, and antithrombotic actions of the omega-3 PUFAs. Specific nursing implications are addressed.
The authors investigated the vasorelaxant properties of the omega-3 fatty acid, docosahexaenoic (... more The authors investigated the vasorelaxant properties of the omega-3 fatty acid, docosahexaenoic (DHA, 22:6n-3), and the possible involvement of endothelium-derived nitric oxide, prostanoids, opening of K+ channels, and/or modulation of calcium-mediated events. Isolated aorta from male spontaneously hypertensive rats (SHR) (age 16-17 weeks) were used to measure isometric tension. DHA-induced (1-100 mumol/l) relaxation was examined following contraction to norepinephrine (NE) (10(-6) mol/l) or high-K+ (80 mmol/l) solution in the presence and absence of various inhibitors and calcium-containing solution. DHA acid induced a significant vasorelaxant effect in both NE and high-K(+)-induced contracted SHR aortic rings, although DHA relaxations were greater in high-K(+)-induced contracted rings. In the absence of extracellular calcium, DHA (5-30 mumol/l) inhibited the initial phasic and sustained components of NE-induced contraction under different conditions. Inhibition of nitric oxide synthesis by N omega-nitro-L-arginine methyl ester hydrochloride (100 mumol/l) had no effect on DHA relaxations; however, indomethacin or nifedipine caused significant inhibition at &gt; or = 30 mumol/l DHA. The K+ channel blocker, glibenclamide, but not tetraethyl-ammonium, also had an inhibitory effect on DHA-induced relaxation. These results indicate that DHA&#39;s vasorelaxant actions in SHR aorta are independent of endothelium-derived nitric oxide; however, at DHA concentrations &gt; or = 30 mumol/l, vasodilatory prostanoids that activate ATP-sensitive K+ channels (KATP) may be involved. At lower concentrations, DHA-induced relaxation appears to be attributed to modulation of intracellular Ca2+ release and L-type Ca2+ channels in vascular smooth muscle cells. The vasorelaxant properties of DHA may contribute, in part, to the blood pressure-lowering effect of dietary fish oil in this hypertensive model.
This article summarizes the highlights of the 1993 Report of the Joint National Committee on Dete... more This article summarizes the highlights of the 1993 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure. These guidelines provide nurses and patients with important information about therapies for hypertension (e.g. lifestyle modification and pharmacologic therapy); treatment for specific populations (e.g. black, young, pregnant, and elderly patients); and, factors which cause hypertension (e.g. cocaine, lithotripsy, cyclosporine, and erythropoietin). This article addresses antihypertensive drugs and provides an algorithm for the treatment of hypertension. The implications for nurses in view of these new guidelines are also presented.
Prostaglandins, leukotrienes, and essential fatty acids, 1993
The effects of oils enriched with gamma-linolenic acid (GLA) on blood pressure and pressor respon... more The effects of oils enriched with gamma-linolenic acid (GLA) on blood pressure and pressor responses were examined in spontaneously hypertensive rats (SHR). Rats were fed purified diets containing evening primrose (EPO), black currant (BCO), borage (BOR) or fungal (FGO) oils for 7 weeks. Significant reductions in blood pressure were obtained in SHR rats maintained on diets enriched with GLA oils. The antihypertensive effect was not associated with enhanced pressor responsiveness to norepinephrine or angiotensin II. Moreover, no differences were found in blood pressure responses to the calcium channel blocker, verapamil. The results suggest that GLA-enriched oils inhibit the development of hypertension in the SHR rat. The blood pressure lowering effect is not mediated by altered pressor responses to vasoconstrictor hormones or intracellular calcium mechanisms.
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Papers by Dr. Marguerite M Engler