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Sunday, November 11, 2018 – Consuming more fish or taking a fish oil supplement may reduce the risk of heart attack, according to a Harvard-led clinical trial.
Heart benefits of omega-3 fatty acids have been found in both healthy people and people with conditions that have put them at increased risk of heart attack, stroke or heart disease, the two studies found.
The vitamin D and Omega-3 process found that healthy people taking a fish oil supplement had fewer heart attacks, especially if they were black or did not regularly eat fish.
Meanwhile, a purified form of omega-3 fatty acid has reduced the risk of death by heart disease, heart attack or stroke in people with hardened arteries or other cardiac risk factors, according to the results of Cardiovascular Cardiovascular Reduction with Icosapent Etil Intervention Trial.
The two studies offer firm evidence that omega 3 fatty acids found in fish such as salmon, sardines or tuna can have a beneficial effect on heart health, said Dr. JoAnn Manson, chief of preventive medicine at Brigham and Boston Women's Hospital researcher for the VITAL study .
"We do not recommend everyone in the world to start taking fish oil supplements." Regarding omega 3s, the best thing to do is try to have more pet food, "said Manson . "If people do not eat fish, there may be some benefits from taking a fish oil supplement. We recommend discussing it with their health care provider."
The results of both clinical trials were presented Saturday at the annual meeting of the American Heart Association of Chicago and will be published simultaneously in the New England Journal of Medicine.
For the VITAL study, nearly 26,000 men from the U.S. and women 50 years of age and over were randomly assigned to take 1 gram of fish oil or 2,000 international units of daily vitamin D or a placebo. The participants had no history of heart problems.
Fish oil supplements reduced the risk of myocardial infarction by 28% over a five-year follow-up period but did not affect the risk of stroke or cancer, the researchers found.
The lower risk of heart attack was found especially in those who have low fish consumption, Manson said. This group had a 19 percent reduction in all major cardiovascular events plus they had a 40 percent reduction in heart attack.
VITAL also found overwhelming benefits of fish oil supplements for black participants, who had a 77% reduction in the risk of heart attack.
If this can be confirmed in a follow-up study, then it could indicate a very promising approach to reduce health disparity, Manson said. Black people tend to have a higher risk of heart disease than white people and other racial groups.
The clinical trial has found no benefit for vitamin D heart health, although it reduced the risk of cancer death by 25%.
Dr. Satjit Bhusri is a cardiologist at the Lenox Hill Hospital in New York City. This is a very important and impressive study. His results will have a lasting change in the prevention of heart disease, "said Bhusri, who was not involved in studies." A reduction in heart attacks this deep has not seen since in primary prevention since the beginning of treatment trials with aspirin.
In the REDUCE-IT study, another research team at Brigham and the Women's Hospital tested the benefits of a pure and stable form of omega-3 fatty acid known as EPA.
The supplement, icosapent ethyl, is a prescription drug approved to lower triglyceride levels in people with high cholesterol.
REDUCE-IT included more than 8,000 patients who took statins to lower cholesterol and prevent either a heart attack or a stroke or a repeated attack. Approximately 7 out of 10 patients in the study had hardened arteries, while the rest had diabetes and at least one other cardiac risk factor.
People who took icosapent ethyl had a 20 percent reduction in the risk of heart-related death, a 31 percent reduction in heart attack and a 28 percent reduction in stroke compared to those who received a placebo, the researchers found.
The REDUCE-IT study sets a new standard of care for patients who have elevated triglycerides and are at increased cardiovascular risk despite statin therapy, lead researcher Dr. Deepak Bhatt, chief executive of cardiovascular intervention programs at Brigham and Women's Hospital , said hospital news in the news. This may be the greatest evolution in cardiovascular prevention from statins.
There are many ways omega-3 fatty acids can help heart health, Manson said. They are known to reduce triglyceride levels, reduce inflammation, diminish blood clotting and help stabilize heart rate.
People interested in taking fish oil supplements should discuss with their doctor first, said Dr. Helene Glassberg, associate professor of cardiovascular medicine at Pennsylvania University Penn Medicine. She was not involved in the studies.
"It has a blood thinning effect. If you're on blood thinning, it may not be for you," Glassberg said.
Glassberg and Manson agree that the best first step would be to increase fish in your diet. Eating at least two servings a week would be good, Manson said.
For someone who is healthy but who seeks to prevent heart disease, "Still on the top of my list is lifestyle," Glassberg said. "Take it in your diet, if you can, from omega-3 fatty fish such as salmon or sardines. This is where you can start because they are natural.
More information
Harvard Medical School has more about omega 3 fatty acids and heart health.
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