Study shows benefit of omega-3s
Paul Morley/Dreamstime.com
Omega-3 oil reduced major coronary events in Japanese population |
Adding an omega-3 fatty acid to standard treatment with a statin provides further protection against major coronary events, a five-year study of Japanese patients with hypercholesterolaemia suggests (Lancet 2007;369:1090).
A total of 18,645 patients with a total cholesterol of 6.5mmol/L or higher
were randomised to receive, in addition to standard therapy with a statin,
either 1,800mg of the omega-3 fatty acid eicosapentaenoic acid (EPA)
or placebo.
After a mean follow-up of 4.6 years, major coronary events (including
sudden cardiac death and fatal and non-fatal myocardial infarction) were
observed less often in the EPA group than in the control group — quantified
as a 19 per cent relative reduction (2.8 per cent versus 3.5 per cent;
P=0.011). However, sub-analyses reveal that sudden cardiac death and
coronary death did not differ between study groups.
The authors say that because the study population was exclusively Japanese,
the results cannot be generalised to people in other countries. They
explain: “In Japan, death from coronary artery disease is rare
and the average intake of fish is about five times higher than that in
other countries.”
Commentary: finding should not be discounted
Dariush Mozaffarian from the departments of medicine and epidemiology,
Harvard Medical School and Harvard School of Public Health, Boston,
Massachusetts, says that the reduction in non-fatal events with
fish oil in the Japanese study should not necessary be discounted.
“In view of the diverse physiological effects of fish oil
and their differing dose-response curves, the main benefit at lower
levels
of consumption might be prevention of primary ventricular arrhythmia,
whereas at high levels of consumption (eg, more than 1g per day
of EPA and DHA), modest benefits for non-fatal coronary events
could also begin to occur because of, for example, triglyceride-lowering,
antihypertensive, or anti-inflammatory effects. Compared with anti-arrhythmic
effects, these effects could require a prolonged duration of consumption
to reduce risk. In this respect, the long follow-up in [the study]
is important: most risk reduction occurred after 2.5 years. Notably,
the benefits were in addition to statin treatment, and fish oil
was safe and generally well tolerated,” he says. |
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