Acute haemodynamic effects of lipolysis-induced increase of free fatty acids in healthy men

Circulating free fatty acids (FFA) are elevated in subjects with insulin resistance and Type II diabetes, and increase during myocardial ischaemia, but their haemodynamic effects are incompletely understood. During an investigation of the effects of FFA on endothelial function, we administered lipid emulsion (150mgċmin^-1 of soybean oil) with heparin (0.2 unitċkg^-1ċmin^-1) intravenously to eight healthy men for 2h. This increased circulating FFA to 3.1±0.5mmol/l. Forearm blood flow was measured by venous occlusion plethysmography during brachial artery infusions of saline, acetylcholine and nitroprusside before, and at 1 and 2h. Lipid/heparin infusion had no significant effect on vasodilation to nitroprusside but progressively increased responses to acetylcholine (from 6.3±2.0 during 30μgċmin^-1 before-lipid infusion to 7.9±1.3 at 1h and 12.2±1.1mlċmin^-1ċ100ml^-1 at 2h, P < 0.001). Basal flow increased from 2.7±0.7 to 4.7±0.8mlċmin^-1ċ100ml^-1 from 0 to 2h. We performed a second study to clarify this effect on basal blood flow. Healthy men (n = 8) received, on separate occasions, 4h intravenous infusions of lipid emulsion with heparin and, as a control, saline with heparin. Lipid with heparin increased mean arterial blood pressure (maximum increment 8.2±2.7mmHg, P < 0.01 compared with saline/heparin control) and forearm blood flow (from 1.7±0.2 to 2.9±0.3mlċmin^-1ċ100ml^-1, P < 0.01) without a significant effect on heart rate, and reduced calculated forearm vascular resistance (from 49.1±5.4 to 31.3±3.9 arbitrary units, P < 0.01). In conclusion, acute elevation of FFA in healthy men increases arterial blood pressure and reduces vascular resistance. These haemodynamic changes could be clinically relevant.