Platelet - vessel wall interaction: influence of diet.

The interaction of platelets with the vessel wall is influenced by the diet. Of major importance is the dietary polyunsaturated fatty acids (PUFA). Epidemiological evidence from Greenland Eskimos with low incidences of acute myocardial infarction has drawn attention to the role of the n - 3 PUFA family. Experiments in vitro have demonstrated an anti-aggregatory effect of eicosapentaenoic acid (EPA). However, EPA does not inhibit vascular prostacyclin production. Antiaggregatory substances generated from EPA have not yet been demonstrated in vivo. Studies in vivo in both animals and humans have demonstrated an antithrombotic effect of EPA. In a study where volunteers were given 6 g EPA per day for 3 weeks, moderate decreases in collagen-induced and ADP-induced platelet aggregation, lower thromboxane B2 (TXB2) synthesis and prolongation of bleeding time were found. These observations indicate the dietary factors modulate the interaction of platelets and the vessel wall. Dietary advice aiming at lowering the incidence of ischaemic diseases must include this aspect. This necessitates a re-evaluation of advice hitherto given to the population in general.