Should We be Recommending Omega-3 Fatty Acid Supplements to Reduce Cardiovascular Risk?

I am not sure if everyone saw a recent JAMA meta-analysis on the role of Omega-3 Fatty Acid Supplements to reduce cardiovascular risk.  It is titled Associations of Omega-3 Fatty Acid Supplement Use With Cardiovascular Disease Risks and it is available free online.  It included 10 trials with 77,917 participants with murine-derived omega-3 fatty acids for a mean of 4.4 years.

Results

Randomization to omega-3 fatty acid supplementation (eicosapentaenoic acid dose range, 226-1800 mg/d) had no significant associations with:

  • Coronary heart disease death (rate ratio [RR], 0.93; 99% CI, 0.83-1.03; P = .05)
  • Nonfatal myocardial infarction (RR, 0.97; 99% CI, 0.87-1.08; P = .43)
  • Any coronary heart disease events (RR, 0.96; 95% CI, 0.90-1.01; P = .12).

Neither did randomization to omega-3 fatty acid supplementation have any significant associations with major vascular events (RR, 0.97; 95% CI, 0.93-1.01; P = .10), overall or in any subgroups, including subgroups composed of persons with prior coronary heart disease, diabetes, lipid levels greater than a given cutoff level, or statin use.

Author’s Conclusion

This meta-analysis demonstrated that omega-3 fatty acids had no significant association with fatal or nonfatal coronary heart disease or any major vascular events. It provides no support for current recommendations for the use of such supplements in people with a history of coronary heart disease.

Implications for Practice

Based on this meta-analysis there is less support for the role of these supplements to reduce the risk of major cardiovascular events.  Clinicians may want to consider the results before recommending these supplements for patients.

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