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A Small Step for Olive Oil as HFpEF Treatment

Extra virgin olive oil (EVOO) showed promise as a secondary prevention therapy for heart failure with preserved ejection fraction (HFpEF) in a small uncontrolled study.

Nine study participants with HFpEF and obesity were supplemented with unsaturated fatty acid-rich foods and had their EVOO intake estimated over 12 weeks according to their dietary recall, according to researchers led by Hayley Billingsley, RD, of Virginia Commonwealth University, who presented the data in a poster at this year’s virtual Heart Failure Society of American meeting.

Daily EVOO intake increased from zero at baseline to 23.6 g on average during the study, with greater EVOO consumption accompanied by small but significant improvements in cardiorespiratory fitness on cardiopulmonary exercise testing (CPET).

A statistical model indicated that a 40-g increase in EVOO intake led to increased peak VO2 by just under 2 mL/kg/min, a roughly 6% improvement compared with predicted peak VO2; oxygen uptake efficiency slope also increased by about 0.1.

The nine people in the study had a median age of 56 years. Five were women, and six people were Black.

Dietary recalls were conducted at baseline, 4, 8, and 12 week visits. Participants underwent CPET at baseline and at 12 weeks.

“Further studies are warranted to confirm this finding and establish a basis for testing the effect of EVOO on cardiorespiratory fitness as well as major cardiovascular outcomes and to explore these effects across differing baseline intakes of EVOO,” Billingsley said.

In particular, more work needs to be done with large, rigorous randomized trials, said Tariq Ahmad, MD, MPH, of Yale University School of Medicine, who was not involved with the study.

However, it is biologically plausible that EVOO may be beneficial for HFpEF, commented C. Noel Bairey Merz, MD, of Cedars-Sinai Medical Center in Los Angeles.

For example, olive oil is known to be high in monounsaturated fat, with lower levels of vitamin E, polyphenols, and lipid molecules that may contribute to its anti-inflammatory and antioxidant properties, one group recently cited from the literature.

Some consider HFpEF to be not one disease but several syndromes, some of which may be related to coronary microvascular dysfunction that is linked to inflammation.

If olive oil does help in HFpEF, it would be a source of hope for those with the condition, as patients currently have no treatments proven to improve their clinical outcomes. Results with sacubitril/valsartan (Entresto) have been mixed in this population, and other options have failed outright.

Ahmad noted a range of limitations to the study, such as lack of information on how patients were diagnosed, absence of a control group, and the small sample size.

Another point of caution is the known training effect in exercise studies, Bairey Merz said.

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    Nicole Lou is a reporter for MedPage Today, where she covers cardiology news and other developments in medicine. Follow

Disclosures

The study was supported by a grant from the NIH.

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