Omega-3 Fatty Acids and Cardiovascular Disease: Summary of the 2016 Agency of Healthcare Research and Quality Evidence Review.

Ethan Balk,Alice Lichtenstein

doi:10.3390/nu9080865

Abstract

We summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality′s evidence review of omega-3 fatty acids and cardiovascular disease (CVD). The overall findings for the effects of marine oil supplements on intermediate CVD outcomes remain largely unchanged. There is high strength of evidence, based on numerous trials, of no significant effects of marine oils on systolic or diastolic blood pressures, but there are small, yet statistically significant increases in high density lipoprotein and low density lipoprotein cholesterol concentrations. The clinical significance of these small changes, particularly in combination, is unclear. The strongest effect of marine oils is on triglyceride concentrations. Across studies, this effect was dose-dependent and related to studies′ mean baseline triglyceride concentration. In observational studies, there is low strength of evidence that increased marine oil intake lowers ischemic stroke risk. Among randomized controlled trials and observational studies, there is evidence of variable strength of no association with increased marine oil intake and lower CVD event risk. Evidence regarding alpha-linolenic acid intake is sparser. There is moderate strength of evidence of no effect on blood pressure or lipoprotein concentrations and low strength of evidence of no association with coronary heart disease, atrial fibrillation and congestive heart failure.

Highlights

The relationship between high fish consumption and low cardiovascular mortality among Greenland Inuit was first reported in the late 1970s
We summarize the 2016 update of the 2004 Agency of Healthcare Research and Quality0 s evidence review of omega-3 fatty acids and cardiovascular disease (CVD)
The major n-3 FAs that are present in food are alpha-linolenic acid (ALA), occurring primarily in plants, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), occurring primarily in marine life

Summary

Introduction

The relationship between high fish consumption and low cardiovascular mortality among Greenland Inuit was first reported in the late 1970s. Numerous observational and intervention studies of fish and omega-3 fatty acids (n-3 FAs) intake have reported similar findings in many countries. The majority of the intervention trials have centered on cardiovascular disease (CVD). The beneficial effects on CVD risk factors and markers have not always been consistent with studies evaluating clinical CVD outcomes. The value of n-3 FA to decrease cardiovascular mortality and improve risk factors remains controversial. The n-3 FAs are a group of long-chain and very-long-chain polyunsaturated fatty acids. The major n-3 FAs that are present in food are alpha-linolenic acid (ALA), occurring primarily in plants, and eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), occurring primarily in marine life

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