text-size: + - R

Hot Topic From RxSchool

New Study Questions Fish Oil Benefit

Darrell Hulisz, RPh, PharmD
Kaylee Adams, Ph

October 1, 2012

A recent study published in the Journal of the American Medical Association casts new doubt on the benefits of omega-3 polyunsaturated fatty acids (O3FA) on hard cardiovascular outcomes in high-risk patients.1 Specifically, the study is a meta-analysis that included 20 randomized studies of 68,680 total participants, evaluating the effect of marine-derived O3FA (fish oil) on all-cause mortality, cardiac death, sudden death, myocardial infarction, and stroke. The studies included for analysis followed patients for a median duration of 2 years. It was found that the use of marine-derived omega-3 polyunsaturated fatty acids does not provide statistically-significant primary or secondary prevention against cardiovascular disease.1 The average daily dose administered was consistent with typical OTC dosing at 1.5 grams per day, with 12 studies administering greater than 1 gram per day.1 Statistical significance of supplementation was not seen with regards to reduced all-cause mortality, sudden death, MI or stroke.1 Cardiac death was the only outcome measure shown to provide a protective risk ratio: 0.91 (0.85-0.98).

The proposed mechanisms for cardiovascular protection are the triglyceride reductive, antiarrhythmic and antihypertensive properties.1,2 These mechanisms are seen to be dose-dependent and of questionable significance.1,2 It is important to note that this meta-analysis does not apply to prescription only omega-3 acid ethyl esters, such as Lovaza,® which are indicated only for the reduction of triglycerides with a daily dosing of 4 grams. Based on the results of this meta-analysis, the authors suggest that there is not enough evidence for universal inclusion of O3FA ingestion into practice guidelines for cardiovascular prevention. However, O3FA ingestion should not be discouraged, as their administration effectively decreases triglyceride levels, does not increase the incidence of cardiovascular events, and are generally well-tolerated.1 Prospective, future research should be conducted to define the role of fish oil supplements in preventing cardiovascular events since current knowledge is still inconclusive.

1. Rizos EC, Ntzani EE, Eftychia B, Kostapanos MS, Elisaf MS. Association between omega-3 fatty acid supplementation and risk of major cardiovascular disease events: A systemic review and meta-analysis. JAMA. Sept 2012. 308;10: 1024-33.

2. Balk E, Lichtenstein A, Chung M, Kupelnick B, Chew P, Lau J. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: A systemic review. Atherosclerosis. March 2006. 189:19-30.

News Topics

Top News Articles