Omega-3 reduces heart problems by ~5 percent – meta-analysis by Heart Association

Created October 2019

Marine Omega‐3 Supplementation and Cardiovascular Disease: An Updated Meta‐Analysis of 13 Randomized Controlled Trials Involving 127,477 Participants

Journal of the American Heart AssociationVol. 8, No. 19, https://doi.org/10.1161/JAHA.119.013543

Yang Hu, Frank B. Hu, and JoAnn E. Manson

1. # Note: This study ignored: Trials using >1800 mg of Omega-3 Ratio of DHA and EPA of th Omega-3 Bioavailability of the Omega-3 used (some suppliers claim 3X more bio-available) Trials which added Vitamin D, Magnesium, Vitamin K, etc. Omega-3 levels in the blood, which vary widely between people due to food consumed, weight, etc. --- * Overview Cardiovascular and vitamin D * Heart Failure and Vitamin D meta-analyses - many studies * Heart attack ICU costs cut in half by Vitamin D – Oct 2018 * Cardiovascular calcification prevented by Omega-3, Magnesium, Vitamin K, and Vitamin D – April 2015 * Signs of low Magnesium (heart problems in this case) – Jan 2018 1. # Items in both categories Omega-3 and Cardiovascular are listed here: {category} 1. Vitamin D and Omega-3 category starts with {include}

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Background

Whether marine omega‐3 supplementation is associated with reduction in risk of cardiovascular disease (CVD) remains controversial.

Methods and Results

This meta‐analysis included study‐level data from 13 trials. The outcomes of interest included myocardial infarction, coronary heart disease (CHD) death, total CHD, total stroke, CVD death, total CVD, and major vascular events. The unadjusted rate ratios were calculated using a fixed‐effect meta‐analysis. A meta‐regression was conducted to estimate the dose–response relationship between marine omega‐3 dosage and risk of each prespecified outcome. During a mean treatment duration of 5.0 years, 3838 myocardial infarctions, 3008 CHD deaths, 8435 total CHD events, 2683 strokes, 5017 CVD deaths, 15 759 total CVD events, and 16 478 major vascular events were documented. In the analysis excluding REDUCE‐IT (Reduction of Cardiovascular Events with Icosapent Ethyl‐Intervention Trial), marine omega‐3 supplementation was associated with significantly lower risk of

  • myocardial infarction (rate ratio [RR] [95% CI]: 0.92 [0.86, 0.99]; P=0.020),

  • CHD death (RR [95% CI]: 0.92 [0.86, 0.98]; P=0.014),

  • total CHD (RR [95% CI]: 0.95 [0.91, 0.99]; P=0.008),

  • CVD death (RR [95% CI]: 0.93 [0.88, 0.99]; P=0.013), and

  • total CVD (RR [95% CI]: 0.97 [0.94, 0.99]; P=0.015).

Inverse associations for all outcomes were strengthened after including REDUCE‐IT while introducing statistically significant heterogeneity. Statistically significant linear dose–response relationships were found for total CVD and major vascular events in the analyses with and without including REDUCE‐IT.

Conclusions

Marine omega‐3 supplementation lowers risk for myocardial infarction, CHD death, total CHD, CVD death, and total CVD, even after exclusion of REDUCE‐IT. Risk reductions appeared to be linearly related to marine omega‐3 dose.

What Is New?

  • We updated previous meta‐analyses by adding 3 recent large randomized controlled clinical trials, increasing sample size by 64% .

  • Marine omega‐3 supplementation significantly lowered risk for most cardiovascular end points, even after excluding a trial testing very high‐dose supplementation.

  • Risk reductions were linearly associated with dose of marine omega‐3 supplementation.

    What Are the Clinical Implications?

Daily marine omega‐3 supplementation is effective in lowering risk for coronary and most other cardiovascular end points, including myocardial infarction, coronary heart disease death, total coronary heart disease, cardiovascular disease death, and total cardiovascular disease; no benefits, however, were found for stroke.

Greater cardiovascular benefits may be achieved at higher doses of marine omega‐ 3 supplementation.

Tags: Cardiovascular Omega-3