- Omega-3 reduces heart problems in both observational and RCT studies - Dr. Manson June 2024
- Omega-3 supplementation and outcomes of heart failure - A systematic review of clinical trials
- VitaminDWiki -
34 studies in both categories Omega-3 and Cardiovascular - See also Cardiovascular Disease is treated by Vitamin D - many studies
Omega-3 reduces heart problems in both observational and RCT studies - Dr. Manson June 2024
Who Benefits From Omega-3/Fish Oil Supplements? - Medscape
5 minute videoThis is Dr JoAnn Manson, professor of medicine at Harvard Medical School and Brigham and Women's Hospital. I'd like to talk with you about a recent report in the British Medical Journal on the regular use of omega-3 fish oil supplements and the course of cardiovascular disease (CVD).
This is an observational study from the large-scale UK Biobank. The authors divided the participants into those with and those without CVD. In participants without CVD at baseline, those using fish oil supplements regularly had an increased incidence of both atrial fibrillation (AF) and stroke, whereas those with prevalent CVD had a reduction in the progression to major adverse cardiovascular events, which offset any increase in the risk for AF.
Observational studies of omega-3 supplements have potential limitations and confounding, and correlation in these studies does not prove causation. What do the randomized clinical trials of omega-3 supplements show? At least seven randomized trials have looked at AF. A meta-analysis published in Circulation in 2021 showed a dose-response relationship. In trials testing > 1 g/d of marine omega-3 fatty acids, there was close to a 50% overall increase in risk for AF. In studies testing lower doses, there was a very modest 12% increase and a significant dose-response gradient.
For the relationship between omega-3 supplements and major cardiovascular events, at least 15 individual randomized trials have been conducted. There actually have been more meta-analyses of these randomized trials than individual trials. The meta-analyses tend to show a significant reduction of coronary events with omega-3 supplementation, but no reduction in stroke. This is true in both primary and secondary prevention trials.
The one exception to this finding is the REDUCE-IT trial testing high-dose eicosapentaenoic acid (EPA) (4 g/day of icosapent ethyl), and there was a 25%-30% reduction in both cardiovascular events and stroke. But there has been some criticism of the mineral oil placebo used in the REDUCE-IT trial that it may have had adverse effects on biomarkers and might have interfered with the absorption of statins in the placebo group. So, it will be important to have a replication trial of the high-dose EPA, findings in a trial using an inert placebo such as corn oil.
What should be done in the meantime? It's important to think about prescription omega-3s vs over-the-counter fish oil. The US Food and Drug Administration (FDA) has approved prescription omega-3 medications for several indications, including severely elevated triglyceride levels (> 500 mg/dL). In the REDUCE-IT trial, those who had moderate elevations of triglycerides (≥ 150 mg/dL) or prevalent CVD or diabetes, plus two additional risk factors, were also considered to have indications based on the FDA labeling for icosapent ethyl.
What about patients who don't meet these criteria for prescription omega-3s? In the VITAL trial (the large-scale primary prevention trial), there was a similar reduction in coronary events but no effect on stroke. Those who seemed to benefit the most in terms of at least 40% reduction in coronary events were participants who had low fish consumption at baseline, had two or more risk factors for cardiovascular disease, or were African American.
Someone who rarely or never eats fish and has multiple risk factors for CVD, but doesn't meet criteria for prescription omega-3 medication, may want to discuss with their clinician the use of over-the-counter fish oil supplements. But fish oil and other dietary supplements will never be a substitute for healthy diet and healthy lifestyle. There is a national recommendation for one to two servings of fish per week. For those planning to take fish oil, it's important to use reputable sources of the supplement, and check the bottle for a quality control seal. It's also really important to avoid megadoses of fish oil, because high doses have been linked to an increased risk for AF and bleeding.
Omega-3 supplementation and outcomes of heart failure - A systematic review of clinical trials
Mahin Nomali, PhDa, Mohammad Eghbal Heidari, PhDb, Aryan Ayati, MD, MPHc, Amirhossein Tayebi, MDd , Oksana Shevchuk, MD, PhDe, Ramin Mohammadrezaei, MDf, Hossein Navid, MDg,
Sayyed Saeid Khayyatzadeh, MDh,i, Svitlana Palii, PhD, MDj, Fahimeh Valizade Shiran, MDk,
Atie Sadat Khorasanian, MSc1, Zahra Veysi, PhDm, Atena Jamalzehi, PhDn, Azadeh Lesani, PhDo,
Golnoosh Assari, BSc, MScp, Shiva Khani, MScq, Kamyab Hassanpour, MDr, Hadis Gerami, PhDh,s*
Backgrounds: Omega-3 supplements are endorsed for heart failure (HF) patients to reduce hospitalizations and mortality, offering anti-inflammatory and cardioprotective benefits.
Methods: A comprehensive search was conducted in various databases until November 2022. Eligible studies included clinical trials on patients with HF. Data extraction covered study details, omega-3 specifics, outcomes, and limitations. The JADAD scale was used to assess the risk of bias in randomized controlled trials.Results: The review process involved 572 records from database searches, resulting in 19 studies after eliminating duplicates and screening. These studies assessed the impact of omega-3 on various clinical outcomes, such as mortality, hospitalization, cardiac function, and quality of life. Studied duration varied from weeks to years. Omega-3 supplementation demonstrated potential benefits such as improved heart function, reduced inflammation, and decreased risk of cardiovascular events.
Conclusion: Omega-3 supplementation could benefit heart disease treatment, potentially reducing therapy duration and improving outcomes. Starting omega-3 supplementation for HF patients seems favorable.
 Download the PDF from VitaminDWiki
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VitaminDWiki -
34 studies in both categories Omega-3 and Cardiovascular This list is automatically updated
- Omega-3 reduces many aspects of heart problems - Jan 2024
- Cardiovascular problems reduced by Omega-3 - many studies
- Cardiovascular problems are prevented by Vitamin D plus Omega-3 – Feb 2023
- Omega-3 decreases heart disease and COVID: Harris and Patrick, video and transcript - Dec 2021
- Atrial Fibrillation decreased by Vitamin D or Magnesium - many studies
- Omega-3 reduced cardiovascular deaths by 16 percent (427,678 people) – March 2020
- Synthetic EPA drug recommended to FDA for Cardio (Omega-3 is 8 X better) – Nov 2019
- Omega-3 reduces heart problems by ~5 percent – meta-analysis by Heart Association Oct 2019
- Cardiovascular Prevention with Omega-3 (finally using high doses) – Sept 2019
- Few people have enough EPA (an Omega-3) to reduce heart failures – July 2019
- Another Nail in the Coffin for Fish Oil Supplements (nope) – JAMA April 2018
- Omega-3 provides many cardiovascular benefits – April 2018
- Omega-3 helps the heart, AHA class II recommendation, more than 1 gm may be needed – March 2018
- 3 days of Omega-3 before cardiac surgery reduced risk of post-op bleeding by half – RCT March 2018
- Perhaps the Omega-3 optimal level is 10 percent, not 8 – Feb 2018
- Omega-3 Cardiovascular meta-analysis has at least 5 major problems – Jan 2018
- Benefits of Omega-3 beyond heart health - LEF Feb 2018
- Higher Omega-3 index (4 to 8 percent) associated with 30 percent less risk of coronary disease (10 studies) July 2017
- Cardiovascular problems reduced by low dose aspirin and perhaps Omega-3 (also Vit K) – Sept 2017
- Omega-3 reduced time in hospital and atrial fibrillation after cardiac surgery – meta-analysis May 2016
- For every Omega-3 dollar there is a 84 dollar savings in Cardiovascular costs - Foster and Sullivan April 2016
- High dose Omega-3 probably reduces heart problems – American Heart Association – March 2017
- Health problems prevented by eating nuts (perhaps due to Magnesium and or Omega-3) – meta-analysis Dec 2016
- Omega-3 – need more than 1 gram for a short time to reduce Cardiovascular Disease – Nov 2016
- Omega-3 is vital for health, mail-in test is low cost and accurate
- Cardiovascular calcification prevented by Omega-3, Magnesium, Vitamin K, and Vitamin D – April 2015
- Atrial fibrillation sometimes treated by Omega-3 – meta-analysis Sept 2015
- Salmon intervention (vitamin D and Omega-3) improved heart rate variability and reduced anxiety – Nov 2014
- Omega-7 - in addition to Omega-3
- Omega-3 reduces Coronary Heart Disease - infographic June 2014
- Cardiovascular diseases – conflicting data on benefits of Omega-3 and vitamin D – Feb 2014
- Cardiovascular system benefits from both Omega-3 and vitamin D – Dec 2012
- Heart problems such as Afib related to little Magnesium, Omega-3, Vitamin D getting to tissues
- Omega-3 does not help heart patients – meta-analysis Sept 2012
See also Cardiovascular Disease is treated by Vitamin D - many studies
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