Abstract
1Department of Medicine, Wegmans Pharmacy, Ithaca, New York, USA 2Department of Medicine, Shifa College of Medicine, Islamabad, Pakistan 3Department of Medicine, Mid American Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA 4Department of Medicine, John Ochsner Heart and Vascular Institute, Ochsner Clinical SchoolThe University of Queensland School of Medicine, New Orleans, LA and Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
Highlights
Omega-3 fatty acids, from fish and supplements, have been shown to reduce the risk of Cardiovascular Diseases (CVD) and all-cause mortality in several epidemiologic studies and Randomized Controlled Trials (RCTs), which has formed the basis of the recommendation of the American Heart Association (AHA) to consume an increased amount of fish by those at risk of CVD [1,2,3]
The Gruppo Italiano per lo Studio della Sopravvivenza2 nell’Infarto Miocardico (GISSI)–Prevention trial was a randomized that enrolled 11,324 patients with a history of Myocardial Infarction (MI) that showed that supplementation with omega-3 fatty acids in leads to a significant decrease in all-cause mortality and mortality due to CVD (RRR 14% [3,4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24] two-way, RRR 20% [6-33] four-way, p = 0.0242) and Coronary Heart Disease (CHD;p =0.0226) [4]
Another study – the DART trial – like the GISSI-Prevention trial was a large RCT conducted on 2,033 men who had suffered a previous MI to assess the effects of inclusion of fatty fish or fish oil in their diet [5]
Summary
Omega-3 fatty acids, from fish and supplements, have been shown to reduce the risk of Cardiovascular Diseases (CVD) and all-cause mortality in several epidemiologic studies and Randomized Controlled Trials (RCTs), which has formed the basis of the recommendation of the American Heart Association (AHA) to consume an increased amount of fish by those at risk of CVD [1,2,3]. The JELIS trial showed that the addition of omega-3 fatty acids to the diet of hypercholesterolaemic patients taking statin drugs leads to a significant further decrease in the incidence of major CHD events (19%, p = 0.011) and that the mechanism of this positive effect is not through the reduction of low density lipoprotein (LDL) cholesterol. A recent meta-analysis conducted on RCTs assessing the effects of omega-3 fatty acids in patients with CHD showed a decrease in the overall risk of non-fatal MI (RR = 0.8 [0.5-1.2], p = 0.16), fatal MI (RR = 0.7 [0.6-0.8], p < 0.001), overall death (RR = 0.8 [0.7-0.9], p < 0.001), and SCD (RR = 0.7 [0.6-0.9], p < 0.01) [10] Another metaanalysis demonstrated a moderate but clinically significant reduction (RR = 0.88 [0.84-0.93]) in the incidence of cerebrovascular diseases in patients with a higher intake of fish as compared to those with a lower intake [11].
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