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Omega 3

Where Do We Stand?

Abstract

Omega-3 fatty acids are essential polyunsaturated fatty acids that are crucial components of plasma membrane phospholipids. They influence cell structure and function and have anti-thrombotic and anti-arrhythmic properties, thus potentially exerting a favourable action on primary and secondary prevention of cardiovascular events. However, the supposed beneficial effect of omega-3 fatty acids in the management of cardiovascular risk has been evaluated only in a relatively small number of interventional studies, with results that are not consistent and are only suggestive of a putative beneficial effect of omega-3 supplementation on the prevention of cardiovascular mortality. Benefits have been reported mainly for the prevention of sudden death in patients with recent myocardial infarction and for primary and secondary prevention of nonfatal cardiac events in populations with high fish intake. Therefore, only ongoing trials will provide definitive data to elucidate whether omega-3 fatty acids could represent a new therapeutic approach for cardiovascular disease.

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Fig. 1.
Table I

References

  1. De Caterina R, Madonna R, Massaro M. Effects of omega-3 fatty acids on cytokines and adhesion molecules. Curr Atheroscler Rep 2004; 6: 485–91

    Article  PubMed  Google Scholar 

  2. Harris WS. Omega-3 fatty acids and cardiovascular disease: a case for omega-3 index as a new risk factor. Pharmacol Res 2007; 55: 217–23

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  3. De Caterina R, Madonna R, Bertolotto A, et al. ω-3 fatty acids in the treatment of diabetic patients: biological rationale and clinical data. Diabetes Care 2007; 30: 1012–26

    Article  PubMed  Google Scholar 

  4. Reiffel JA, McDonald A. Antiarrhythmic effects of omega-3 fatty acids. Am J Cardiol 2006; 98: 50i–60i

    CAS  Article  PubMed  Google Scholar 

  5. Jacobson TA. Secondary prevention of coronary artery disease with omega-3 fatty acids. Am J Cardiol 2006; 98: 61i–70i

    CAS  Article  PubMed  Google Scholar 

  6. Wang C, Harris WS, Chung M, et al. ω-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: a systematic review. Am J Clin Nutr 2006; 84: 5–17

    CAS  PubMed  Google Scholar 

  7. Calo L, Bianconi L, Colivicchi F, et al. ω-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol 2005; 45: 1723–8

    CAS  Article  PubMed  Google Scholar 

  8. Riatt MH, Connor WE, Morris C, et al. Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial. JAMA 2005; 293: 2884–91

    Article  Google Scholar 

  9. Leaf A, Albert CM, Josephson M, et al. Prevention of fatal arrhythmias in high-risk subjects by fish oil ω-3 fatty acid intake. Circulation 2005; 112: 2762–8

    CAS  Article  PubMed  Google Scholar 

  10. Brouwer IA, Zock PL, Camm AJ, et al. Effect of fish oil on ventricular tachyarrhythmia and death in patients with implantable cardioverter defibrillators: the Study on Omega-3 Fatty Acids and Ventricular Arrhythmia (SOFA) randomized trial. JAMA 2006; 295: 2613–9

    CAS  Article  PubMed  Google Scholar 

  11. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Dietary supplementation with ω-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999; 354: 447–55

    Article  Google Scholar 

  12. Thies F, Garry JM, Yaqoob P, et al. Association of ω-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial. Lancet 2003; 361: 477–85

    CAS  Article  PubMed  Google Scholar 

  13. von Schacky C, Angerer P, Kothny W, et al. The effect of dietary omega-3 fatty acids on coronary atherosclerosis: a randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999; 130: 554–62

    Article  Google Scholar 

  14. Eritsland J, Arnesen H, Gronseth K, et al. Effect of dietary supplementation with ω-3 fatty acids on coronary artery bypass graft patency. Am J Cardiol 1996; 77: 31–6

    CAS  Article  PubMed  Google Scholar 

  15. Balk EM, Lichtenstein AH, Chung M, et al. Effects of omega-3 fatty acids on coronary restenosis, intima-media thickness, and exercise tolerance: a systematic review. Atherosclerosis 2006; 184: 237–46

    CAS  Article  PubMed  Google Scholar 

  16. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): a randomised open-label, blinded endpoint analysis. Lancet 2007; 369: 1090–8

    CAS  Article  PubMed  Google Scholar 

  17. von Schacky C. Omega-3 fatty acids and cardiovascular disease. Curr Opin Clin Nutr Metab Care 2004; 7: 131–6

    Article  Google Scholar 

  18. Mori TA, Watts GF, Burke V, et al. Differential effects of eicosapentaenoic acid and docosahexaenoic acid on vascular reactivity of the forearm microcirculation in hyperlipidemic, overweight men. Circulation 2000; 102: 1264–9

    CAS  Article  PubMed  Google Scholar 

  19. Theobald HE, Goodall AH, Sattar N, et al. Low-dose docosahexaenoic acid lowers diastolic blood pressure in middle-aged men and women. J Nutr 2007; 137: 973–8

    CAS  PubMed  Google Scholar 

  20. Dickinson HO, Mason JM, Nicolson DJ, et al. Lifestyle interventions to reduce raised blood pressure: a systematic review of randomized controlled trials. J Hypertens 2006; 24: 215–33

    CAS  Article  PubMed  Google Scholar 

  21. Mancia G, De Backer G, Dominiczak A, et al. 2007 Guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25: 1105–87

    CAS  Article  PubMed  Google Scholar 

  22. Balk EM, Lichtenstein AH, Chung M, et al. Effects of omega-3 fatty acids on serum markers of cardiovascular disease risk: a systematic review. Atherosclerosis 2006; 189: 19–30

    CAS  Article  PubMed  Google Scholar 

  23. He K, Song Y, Daviglus ML, et al. Accumulated evidence on fish consumption and coronary heart disease mortality: a meta-analysis of cohort studies. Circulation 2004; 109: 2705–11

    Article  PubMed  Google Scholar 

  24. He K, Song Y, Daviglus ML, et al. Fish consumption and incidence of stroke: a meta-analysis of cohort studies. Stroke 2004; 35: 1538–42

    Article  PubMed  Google Scholar 

  25. Lichtenstein AH, Appel LJ, Brands M, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 2006; 114: 82–96

    Article  PubMed  Google Scholar 

  26. Harper CR, Jacobson TA. Usefulness of omega-3 fatty acids and the prevention of coronary heart disease. Am J Cardiol 2005; 96: 1521–9

    CAS  Article  PubMed  Google Scholar 

  27. 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: 757–61

    CAS  Article  PubMed  Google Scholar 

  28. Burr ML, Ashfield-Watt PA, Dunstan FD, et al. Lack of benefit of dietary advice to men with angina: results of a controlled trial. Eur J Clin Nutr 2003; 57: 193–200

    CAS  Article  PubMed  Google Scholar 

  29. Ness AR, Hughes J, Elwood PC, et al. The long-term effect of dietary advice in men with coronary disease: follow-up of the Diet and Reinfarction trial (DART). Eur J Clin Nutr 2002; 56: 512–8

    CAS  Article  PubMed  Google Scholar 

  30. Hooper L, Thompson RL, Harrison RA, et al. Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review. BMJ 2006; 332: 752–60

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  31. Marchioli R, Barzi F, Bomba E, et al. Early protection against sudden death by ω-3 polyunsaturated fatty acids after myocardial infarction: time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico (GISSI)-Prevenzione. Circulation 2002; 105: 1897–903

    CAS  Article  PubMed  Google Scholar 

  32. Macchia A, Levantesi G, Franzosi MG, et al. Left ventricular systolic dysfunction, total mortality, and sudden death in patients with myocardial infarction treated with ω-3 polyunsaturated fatty acids. Eur J Heart Fail 2005; 7: 904–9

    CAS  Article  PubMed  Google Scholar 

  33. Nilsen DW, Albrektsen G, Landmark K, et al. Effects of a high-dose concentrate of ω-3 fatty acids or corn oil introduced early after an acute myocardial infarction on serum triacylglycerol and HDL cholesterol. Am J Clin Nutr 2001; 74: 50–6

    CAS  PubMed  Google Scholar 

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Acknowledgements

No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.

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Correspondence to Antonio Salvetti.

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Versari, D., Daghini, E., Salvetti, G. et al. Omega 3. High Blood Press Cardiovasc Prev 15, 225–230 (2008). https://doi.org/10.2165/0151642-200815040-00002

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  • DOI: https://doi.org/10.2165/0151642-200815040-00002

Key words

  • omega-3 fatty acids
  • inflammation
  • atherosclerosis
  • cardiovascular prevention
  • cardiovascular disease