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Amanda Jekowsky , American College of
Cardiology, 202-375-6645, ajekowsk@acc.org
August
3, 2009
Study Reveals Mounting Evidence of Fish Oil’s Heart
Health Benefits
Researchers set forth recommendations for daily
intake
There is mounting evidence that omega-3 fatty acids from fish
or fish oil supplements not only help prevent cardiovascular
diseases in healthy individuals, but also reduce the incidence
of cardiac events and mortality in patients with existing
heart disease. A new study, published in the August 11, 2009,
issue of the Journal of the American College of Cardiology,
extensively reviews data from a broad range of studies in
tens of thousands of patients and sets forth suggested daily
targets for omega-3 consumption.
“This isn’t just hype; we now have tremendous
and compelling evidence from very large studies, some dating
back 20 and 30 years, that demonstrate the protective benefits
of omega-3 fish oil in multiple aspects of preventive cardiology,”
said Carl Lavie, M.D., F.A.C.C., medical director of Cardiac
Rehabilitation and Prevention, Ochsner Medical Center, New
Orleans, LA, and lead author of the article. “The strongest
evidence of a cardioprotective effect of omega-3s appears
in patients with established cardiovascular disease and following
a heart attack with up to a 30 percent reduction in CV-related
death.”
Dietary intake of fish oil can also decrease the risk of
atherosclerosis, arrhythmias, heart attack, sudden cardiac
death and even health failure. Dr. Lavie adds that although
there is a smaller benefit in reducing heart failure death—9
percent mortality benefit in a major recent randomized controlled
trial—this is still very impressive given patients’
grave prognosis.
“If we translate this finding, it means that we only
need to treat 56 patients for four years to prevent one death,”
he said. “And we are talking about a very safe and relatively
inexpensive therapy.”
Most of the evidence for the cardioprotective benefits supports
the use of DHA (docosahexaenoic acid) and EPA (eicosapentaenoic
acid), the long-chain fatty acids in the omega-3 family. According
to Dr. Lavie, EPA and DHA work by getting into the membranes
of cells and, in doing so, may help to improve the heart’s
electrical activity, vascular tone, plaque stabilization and
blood pressure, among other benefits. Studies show that the
reduction in CV events is inversely related to the tissue
level EPA and, even more so, DHA.
Based on these findings, and because the body does not produce
its own essential fatty acids, the authors recommend that
healthy individuals should consume 500 mg daily of omega-3
fish oil containing EPA and DHA, and people with known heart
disease or heart failure aim for at least 800 to 1,000 mg
daily.
“There are clear health and heart benefits associated
with increasing one’s intake of foods that are rich
in Omega-3s, including oily fish like salmon, sardines, trout,
herring, and oysters” said Dr. Lavie “Patients
should talk with their doctors about whether a fish oil supplement
is needed to get the right amount and, in turn, benefit from
the associated cardiovascular protection.”
Dr. Lavie and his team came across only a few negative studies,
including a recent one that showed no benefit in post-MI patients,
but it has raised the possibility that omega-3 fatty acids
may not provide as much additional protective benefits in
low-risk patients already receiving extensive and rigorous
post-MI therapies. “It was a one-year study that enrolled
fewer than 4,000 patients and the majority were using aspirin,
clopidogrel, statins, beta-blockers and ACE-inhibitors—the
best of modern medicine,” he said. “It may be
that their risk was so low to start, that a larger study with
longer follow-up would be required to better assess the true
efficacy of omega-3 in such relatively low-risk patients.”
Authors say further studies are needed to investigate and
determine optimal dosages, as well as the relative ration
of DHA and EPA that provides maximal heart protection in those
at risk of cardiovascular disease, and in the treatment of
atherosclerosis, arrhythmias and heart attacks.
Interestingly, culture has historically played a role; sometimes
dubbed the “Eskimo factor,” research shows cultures
that have traditionally supported a diet rich in fish oil
(Asian and Alaskan American populations) had a lower prevalence
of cardiovascular disease and mortality, including a reduced
prevalence of atherosclerosis and heart disease, compared
to European and United States populations where consumption
of fish is lower. Ironically, the introduction of Western
dietary practices into Asian and Native American cultures
may be diluting the cardioprotective benefits enjoyed by these
populations by both reducing the overall intake of fish oils,
as well as overwhelming its benefits with other deleterious
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The American College of Cardiology is leading the way to optimal
cardiovascular care and disease prevention. The College is
a 36,000-member nonprofit medical society and bestows the
credential Fellow of the American College of Cardiology upon
physicians who meet its stringent qualifications. The College
is a leader in the formulation of health policy, standards
and guidelines, and is a staunch supporter of cardiovascular
research. The ACC provides professional education and operates
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online at www.acc.org .
The American College of Cardiology (ACC) provides these news
reports of clinical studies published in the Journal of
the American College of Cardiology as a service to physicians,
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statements or opinions expressed in these reports reflect
the view of the author(s) and do not represent official policy
of the ACC unless stated so.
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