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The Pharmaceutical Journal
Vol 269 No 7225 p736
23 November 2002

Related websites
Circulation: Scientific statement (more)

Patients with coronary heart disease should consider fish oil supplements

Patients with coronary heart disease (CHD) should consume one serving of oily fish or three fish oil supplement capsules a day, according to new recommendations from the American Heart Association.

The AHA already advises that everyone should eat at least two servings of fish each week but has now expanded its guidance to include recommendations for patients with documented CHD and for patients with raised triglyceride levels.

Dr Penny Kris-Etherton, professor of nutrition at Pennsylvania State University, and Dr William Harris, from the AHA nutrition committee, put forward the recommendations at the AHA annual scientific sessions held in Chicago earlier this week. They said that people with CHD should consume 1g of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) every day. Patients with raised triglyceride levels should consume 2–4g of EPA/DHA per day.

The AHA says that a dietary approach to increasing omega-3 fatty acids is preferable but acknowledges that for patients with CHD or raised triglyceride levels these doses may be greater than can be readily achieved through diet alone. "For these individuals who cannot or will not eat fish the evidence supports the use of supplements to decrease the risk of heart disease and stroke," Dr Harris said.

Dr Harris pointed out that most fish oil supplements contain about 0.3g of EPA/DHA, so three capsules would be needed to approximate the recommended daily dose for patients with CHD. He added that one capsule of Omacor, launched last week in the United Kingdom (PJ, 16 November, p700), provides 1g of EPA/DHA.

The recommendations are also published this week in Circulation (2002; 106:2747).

Omega-3 fatty acids for children with high cholesterol Data presented at the AHA meeting suggest that DHA supplementation in children with high cholesterol levels improves endothelial function.

A total of 14 children were given either a supplement of DHA or placebo for six weeks after eating a low fat diet for a similar period.

Using an ultrasound technique the researchers measured changes in the size of blood vessels in response to increases in blood flow. They found that dilation of the blood vessels increased from 6.0 (±2.1) per cent to 6.3 (±2.8) per cent after six weeks of a low fat diet and then increased to 8.2 (±3.0) per cent after DHA supplementation (P<0.001).