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Omega-3 fatty acids and the heart: New evidence, more questions

May 17, 2021

Omega-3 fatty acids show benefit in REDUCE-IT trial and win FDA approval

Two main omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are found mainly in fish and fish oil. Omega-3s from fish and fish oil have been recommended by the American Heart Association (AHA) for the past 20 years to reduce cardiovascular events, like heart attack or stroke, in people who already have cardiovascular disease (CVD). I have written about and been a strong advocate of getting omega-3s through diet, and sometimes through the use of supplements.

Over the past year I have prescribed an omega-3, sold under the brand name Vascepa, to my patients who are at high risk for CVD, based on evidence of cardiovascular benefits. Vascepa contains purified EPA, and its use is based on good clinical data from the REDUCE-IT trial. This study enrolled over 8,000 patients with elevated cardiovascular risk and high blood triglyceride levels. They assigned half of the study participants to receive 2 grams of Vascepa twice a day, and assigned the other participants a placebo (a pill filled with mineral oil). The results showed a significant benefit of Vascepa over the placebo. Vascepa reduced blood triglyceride levels, but more importantly, it reduced the number of heart attacks and strokes, the need for a heart stenting procedure to open clogged arteries, and death.

A subsequent meta-analysis, which included data from over 10 studies, found fish oil omega‐3 supplements lowered risk for heart attack and death from coronary heart disease.