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Is Omega-3 Pointless for Preventing Heart Disease?

— Meta-analysis showed no significant link to coronary disease, any major vascular events

Last Updated February 1, 2018
MedpageToday

Omega-3 fatty acids have gotten a heart-healthy reputation without good evidence that they actually prevent major cardiovascular disease events, according to a meta-analysis.

Across 10 large randomized trials lasting at least 1 year, taking the supplements was not associated with significantly reduced risk of:

  • Death from coronary heart disease: rate ratio 0.93 (99% CI 0.83-1.03)
  • Nonfatal myocardial infarction: RR 0.97 (99% CI 0.87-1.08)
  • Any coronary heart disease events: RR 0.96 (95% CI 0.90-1.01)
  • Major vascular events: RR 0.97 (95% CI 0.93-1.01)

Benefits also weren't seen in subgroups with prior coronary heart disease, diabetes, elevated lipid levels, or statin use, Robert Clarke, MD, of the University of Oxford in England, and colleagues reported in JAMA Cardiology.

While the European Society of Cardiology has called a protective effect of omega-3s , the American Heart Association has for secondary prevention of coronary heart disease in patients with recent events and "might also be considered" in people with heart failure and reduced ejection fraction.

"However, the results of the present meta-analysis provide no support for the recommendations to use approximately 1 g/d of omega-3 FAs in individuals with a history of CHD for the prevention of fatal CHD, nonfatal MI, or any other vascular events," Clarke's group concluded. "The results of the ongoing trials are needed to assess if higher doses of omega-3 [fatty acids] (3-4 g/d) may have significant effects on risk of major vascular events."

Disclosures

The study was supported by the British Heart Foundation, British Heart Foundation Centre for Research Excellence Oxford, and Medical Research Council Clinical Trial Service Unit.

Clarke disclosed no relevant relationships with industry. Co-authors disclosed multiple relevant relationships with industry.

Primary Source

JAMA Cardiology

"Associations of omega-3 fatty acid supplement use with cardiovascular disease risks: Meta-analysis of 10 trials involving 77,917 individuals" JAMA Cardiol 2018; DOI:10.1001/jamacardio.2017.5205.