Current Atherosclerosis Reports

, Volume 3, Issue 2, pp 174–179 | Cite as

Clinical trial evidence for the cardioprotective effects of omega-3 fatty acids

  • William S. Harris
  • William L. Isley


The notion that marine omega (ω)-3 fatty acids might have beneficial cardiovascular effects was first suggested by epidemiologic studies in Greenland Inuits published in the late 1970s. These simple observations spawned hundreds of other studies, the confluence of which strongly suggests a true cardioprotective effect of ω-3 fatty acids. The strongest confirmation has come from the publication of three randomized clinical trials, all of which reported benefits to patients with preexisting coronary artery disease. The most convincing of these was the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico (GISSI)-Prevezione study, in which 5654 patients with coronary artery disease were randomized to either ω-3 fatty acids (850 mg/d) or usual care. After 3.5 years, those taking the ω-3 fatty acids had experienced a 20% reduction in overall mortality and a 45% decrease in risk for sudden cardiac death. These findings support the view that relatively small intakes of ω-3 fatty acids are indeed cardioprotective, and suggest that they may operate by stabilizing the myocardium itself.


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References and Recommended Reading

  1. 1.
    Bang HO, Dyerberg J: Lipid Metabolism and Ischemic Heart Disease in Greenland Eskimos. In Advances in Nutrition Research, Edited by Draper H. New York: Plenum Press; 1980:1–22.Google Scholar
  2. 2.
    GISSI-Prevenzione Investigators: Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E in 11,324 patients with myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999, 354:447–455.CrossRefGoogle Scholar
  3. 3.
    Scandinavian Simvastatin Survival Study Group: Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994, 344:1383–1389.CrossRefGoogle Scholar
  4. 4.
    Leaf A: Cardiovascular effects of fish oils: beyond the platelet. Circulation 1990, 82:624–628.PubMedGoogle Scholar
  5. 5.
    Chin JPF: Marine oils and cardiovascular reactivity. Prostag Leuko Ess FAs 1994, 50:211–222.CrossRefGoogle Scholar
  6. 6.
    De Caterina R, Cybulsky MA, Clinton SK, et al.: Omega-3 Fatty Acids and Endothelial Leukocyte Adhesion Molecules. Prostag Leuko Ess FAs 1995, 52:191–195.CrossRefGoogle Scholar
  7. 7.
    Harris WS: n-3 Fatty acids and serum lipoproteins: human studies. Am J Clin Nutr 1997, 65:1645S-1654S.PubMedGoogle Scholar
  8. 8.
    Sacks FM, Pfeffer MA, Moye LA, et al.: The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. New Engl J Med 1996, 335:1001–1009.PubMedCrossRefGoogle Scholar
  9. 9.
    The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group: Prevention of cardiovascular events and death with Pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Eng J Med 1998, 339:1349–1357.CrossRefGoogle Scholar
  10. 10.
    Burr ML, Fehily AM, Gilbert JF, et al.: Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989, 2:757–761.PubMedCrossRefGoogle Scholar
  11. 11.
    Burr ML, Sweetnam PM, Fehily AM: Diet and reinfarction. Eur Heart J 1994, 15:1152–1153.PubMedGoogle Scholar
  12. 12.
    Black KL, Culp B, Madison D, et al.: The protective effects of dietary fish oil on focal cerebral infarction. Prostag Med 1979, 3:257–268.CrossRefGoogle Scholar
  13. 13.
    Culp BR, Lands WEM, Lucchesi BR, et al.: The Effect of dietary supplementation of fish oil on experimental myocardial infarction. Prostaglandins 1980, 20:1021–1031.PubMedCrossRefGoogle Scholar
  14. 14.
    McLennan PL, Abeywardena MY, Charnock JS: Dietary fish oil prevents ventricular fibrillation following coronary artery occlusion and reperfusion. Am Heart J 1988, 116:709–717.PubMedCrossRefGoogle Scholar
  15. 15.
    McLennan PL, Abeywardena MY, Charnock JS: Reversal of the arrhythmogenic effects of long-term saturated fatty acid intake by dietary n-3 and n-6 polyunsaturated fatty acids. Am J Clin Nutr 1990, 51:53–58.PubMedGoogle Scholar
  16. 16.
    Kang JX, Leaf A: Antiarrhythmic effects of polyunsaturated fatty acids. Recent Studies. Circulation 1996, 94:1774–1780.PubMedGoogle Scholar
  17. 17.
    Billman GE, Kang JX, Leaf A: Prevention of Sudden Cardiac Death by Dietary Pure w-3 Polyunsaturated Fatty Acids in Dogs. Circulation 1999, 99:2452–2457.PubMedGoogle Scholar
  18. 18.
    Siscovick DS, Raghunathan TE, King I, et al.: Dietary intake and cell membrane levels of long-chain n-3 polyunsaturated fatty acids and the risk of primary cardiac arrest. J Am Med Assoc 1995, 274:1363–1367.CrossRefGoogle Scholar
  19. 19.
    Singh RB, Niaz MA, Sharma JP, et al.: Randomized, double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: the indian experiment of infarct survival. Cardiovasc Drugs Ther 1997, 11:485–491.PubMedCrossRefGoogle Scholar
  20. 20.
    Food and Drug Administration, HHS: Substances affirmed as generally recognized as safe: menhaden oil. Federal Register, 30751–30757. June 5, 1997.Google Scholar
  21. 21.
    Shepherd J, Cobbe SM, Ford I, et al.: Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995, 333:1301–1307.PubMedCrossRefGoogle Scholar
  22. 22.
    Downs JR, Clearfield M, Weis S, et al.: Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS: Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA 1998, 279:1615–1622.PubMedCrossRefGoogle Scholar
  23. 23.
    Guallar E, Hennekens CH, Sacks FM, et al.: A prospective study of plasma fish oil levels and incidence of myocardial infarction in U.S. male physicians. J Am Coll Cardiol 1995, 25:387–394.PubMedCrossRefGoogle Scholar
  24. 24.
    Daviglus ML, Stamler J, Orencia AJ, et al.: Fish consumption and the 30-year risk of fatal myocardial infarction. N Eng J Med 1997, 336:1046–1053.CrossRefGoogle Scholar
  25. 25.
    Ascherio A, Rimm EB, Stampfer MJ, et al.: Dietary intake of marine n-3 fatty acids, fish intake, and the risk of coronary disease among men. N Engl J Med 1995, 332:977–982.PubMedCrossRefGoogle Scholar
  26. 26.
    Albert CM, Hennekens CH, O’Donnell CJ, et al.: Fish Consumption and risk of sudden cardiac death. JAMA 1998, 279:23–28.PubMedCrossRefGoogle Scholar
  27. 27.
    Kromhout D, Bosschieter EB, de Lezenne Coulander C: The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med 1985, 312:1205–1209.PubMedCrossRefGoogle Scholar
  28. 28.
    Burchfiel CM, Reed DM, Strong JP, et al.: Predictorsrs of myocardial lesions in men with minimal at autopsy: the Honolulu Heart Program. Ann Epidemiol 1996, 6:137–146.PubMedCrossRefGoogle Scholar
  29. 29.
    Rubins HB, Robins SJ, Collins D, et al.: Gemfibrozil for the secondary prevention of coronary heart disease in men with low levels of high-density lipoprotein cholesterol: Veterans Affairs High-Density Lipoprotein Cholesterol Intervention Trial Study Group. N Eng J Med 1999, 341:410–418.CrossRefGoogle Scholar
  30. 30.
    de Lorgeril M, Salen P, Martin JL, et al.: Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation 1999, 99:779–785.PubMedGoogle Scholar

Copyright information

© Current Science Inc 2001

Authors and Affiliations

  • William S. Harris
    • 1
  • William L. Isley
    • 1
  1. 1.Mid America Heart Institute of Saint Luke’s Hospital and Department of MedicineUniversity of Missouri-Kansas CityKansas CityUSA

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