Skip to main content
SpringerLink
Log in

Extending the cardiovascular benefits of omega-3 fatty acids

  • Published:
Current Atherosclerosis Reports Aims and scope Submit manuscript

Abstract

The cardiovascular benefits of omega (n)-3 fatty acids (FA) become clearer with each passing year. Although useful in large doses for lowering serum triglyceride levels, the primary benefits are likely to arise from smaller, nutritional intakes of eicosapentaenoic acid (EPA) and docosahexanoic acid (DHA). Doses of less than 1 g/d appear to reduce risk for fatal coronary heart disease events, perhaps by stabilizing the myocardium and reducing risk for fatal arrhythmias. New evidence points to a possible benefit on atrial fibrillation, particularly in the immediate post-cardiac surgery setting. Studies in women with coronary heart disease now suggest that plaque progression may be slowed by increased intakes of oily fish, even in women with diabetes. The relative importance of the n-6 FA linoleic acid (LA), the short-chain n-3 FA alpha linolenic acid (ALA), and the long-chain n-3 FAs EPA and DHA is becoming clearer. If intakes of the latter are adequate (perhaps over 250 mg/d), then there appears to be little need to consume more ALA or less LA.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Kris-Etherton PM, Harris WS, Appel LJ: Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002, 106:2747–2757.

    Article  PubMed  Google Scholar 

  2. Harris WS, von Schacky C: The Omega-3 Index: a new risk factor for sudden cardiac death? Prev Med 2004, 39:212–220.

    Article  PubMed  CAS  Google Scholar 

  3. Mozaffarian D, Ascherio A, Hu FB, et al.: Interplay between different polyunsaturated fatty acids and risk of coronary heart disease in men. Circulation 2005, 111:157–164.

    Article  PubMed  CAS  Google Scholar 

  4. Mozaffarian D, Longstreth WT Jr, Lemaitre RN, et al.: Fish consumption and stroke risk in elderly individuals: the cardiovascular health study. Arch Intern Med 2005, 165:200–206.

    Article  PubMed  Google Scholar 

  5. Mozaffarian D, Lemaitre RN, Kuller LH, et al.: Cardiac benefits of fish consumption may depend on the type of fish meal consumed: the Cardiovascular Health Study. Circulation 2003, 107:1372–1377.

    Article  PubMed  Google Scholar 

  6. Virtanen JK, Voutilainen S, Rissanen TH, et al.: Mercury, fish oils, and risk of acute coronary events and cardiovascular disease, coronary heart disease, and all-cause mortality in men in eastern Finland. Arterioscler Thromb Vasc Biol 2005, 25:228–233.

    PubMed  CAS  Google Scholar 

  7. Hites RA, Foran JA, Carpenter DO, et al.: Global assessment of organic contaminants in farmed salmon. Science 2004, 303:226–229.

    Article  PubMed  CAS  Google Scholar 

  8. 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.

    Article  Google Scholar 

  9. Studer M, Briel M, Leimenstoll B, et al.: Effect of different antilipidemic agents and diets on mortality: a systematic review. Arch Intern Med 2005, 165:725–730.

    Article  PubMed  CAS  Google Scholar 

  10. 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.

    PubMed  Google Scholar 

  11. Singh RB, Dubnov G, Niaz MA, et al.: Effect of an Indo-Mediterranean diet on progression of coronary artery disease in high risk patients (Indo-Mediterranean Diet Heart Study): a randomised single-blind trial. Lancet 2002, 360:1455–1461.

    Article  PubMed  Google Scholar 

  12. 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—4. Cardiovasc Drugs Ther 1997, 11:485–491.

    Article  PubMed  CAS  Google Scholar 

  13. von Schacky C: The role of omega-3 fatty acids in cardiovascular disease. Curr Atheroscler Rep 2003, 5:139–145.

    Google Scholar 

  14. Harris WS: Alpha linolenic acid—a gift from the land? Circulation 2005, 111:2872–2874.

    Article  PubMed  Google Scholar 

  15. Sacks FM, Stone PH, Gibson CM, et al.: Controlled trial of fish oil for regression of human coronary atherosclerosis. J Am Coll Cardiol 1995, 25:1492–1498.

    Article  PubMed  CAS  Google Scholar 

  16. Leaf A, Jorgensen MB, Jacobs AK, et al.: Do fish oils prevent restenosis after coronary angioplasty? Circulation 1994, 90:2248–2257.

    PubMed  CAS  Google Scholar 

  17. Dehmer GJ, Popma JJ, van den Berg EK, et al.: Reduction in the rate of early restenosis after coronary angioplasty by a diet supplemented with n-3 fatty acids. N Engl J Med 1988, 319:733–740.

    Article  PubMed  CAS  Google Scholar 

  18. Thies F, Garry JM, Yaqoob P, et al.: Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial. Lancet 2003, 361:477–485.

    Article  PubMed  CAS  Google Scholar 

  19. Herrington DM, Reboussin DM, Brosnihan KB, et al.: Effects of estrogen replacement on the progression of coronary-artery atherosclerosis. N Engl J Med 2000, 343:522–529.

    Article  PubMed  CAS  Google Scholar 

  20. Erkkila AT, Lichtenstein AH, Mozaffarian D, Herrington DM: Fish intake is associated with a reduced progression of coronary artery atherosclerosis in postmenopausal women with coronary artery disease. Am J Clin Nutr 2004, 80:626–632.

    PubMed  Google Scholar 

  21. Mori TA, Woodman RJ, Burke V, et al.: Effect of eicosapentaenoic acid and docosahexaenoic acid on oxidative stress and inflammatory markers in treated-hypertensive type 2 diabetic subjects. Free Radic Biol Med 2003, 35:772–781.

    Article  PubMed  CAS  Google Scholar 

  22. Zhao G, Etherton TD, Martin KR, et al.: Dietary alpha-linolenic acid reduces inflammatory and lipid cardiovascular risk factors in hypercholesterolemic men and women. J Nutr 2004, 134:2991–2997.

    PubMed  CAS  Google Scholar 

  23. Hjerkinn EM, Seljeflot I, Ellingsen I, et al.: Influence of long-term intervention with dietary counseling, long-chain n-3 fatty acid supplements, or both on circulating markers of endothelial activation in men with long-standing hyperlipidemia. Am J Clin Nutr 2005, 81:583–589.

    PubMed  CAS  Google Scholar 

  24. Libby P, Ridker PM, Maseri A: Inflammation and atherosclerosis. Circulation 2002, 105:1135–1143.

    Article  PubMed  CAS  Google Scholar 

  25. Dyerberg J, Eskesen DC, Andersen PW, et al.: Effects of trans- and n-3 unsaturated fatty acids on cardiovascular risk markers in healthy males. An 8 week dietary intervention study. Eur J Clin Nutr 2004, 58:1062–1070.

    Article  PubMed  CAS  Google Scholar 

  26. 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.

    Article  Google Scholar 

  27. Nilsen DW, Albrektsen G, Landmark K, et al.: Effects of a high-dose concentrate of n-3 fatty acids or corn oil introduced early after acute myocardial infarction on serum triacylglycerol and HDL cholesterol. Am J Clin Nutr 2001, 74:50–56.

    PubMed  CAS  Google Scholar 

  28. von Schacky C, Angerer P, Kothny W, et al.: The effect of dietary w-3 fatty acids on coronary atherosclerosis, a randomized, double-blind, placebo-controlled trial. Ann Intern Med 1999, 130:554–562.

    Google Scholar 

  29. 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.

    Article  PubMed  CAS  Google Scholar 

  30. 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.

    PubMed  CAS  Google Scholar 

  31. Leaf A, Kang JX, Xiao YF, Billman GE: Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation 2003, 107:2646–2652.

    Article  PubMed  Google Scholar 

  32. Christensen JH, Skou HA, Madsen T, et al.: Heart rate variability and n-3 polyunsaturated fatty acids in patients with diabetes mellitus. J Intern Med 2001, 249:545–552.

    Article  PubMed  CAS  Google Scholar 

  33. Christensen JH, Christensen MS, Dyerberg J, Schmidt EB: Heart rate variability and fatty acid content of blood cell membranes: a dose response study with n-3 fatty acids. Am J Clin Nutr 1999, 70:331–337.

    PubMed  CAS  Google Scholar 

  34. Geelen A, Zock PL, Swenne CA, et al.: Effect of n-3 fatty acids on heart rate variability and baroreflex sensitivity in middle-aged subjects. Am Heart J 2003, 146:E4.

    Google Scholar 

  35. Geelen A, Bouwer IA, Schouten EG, et al.: Effects of n-3 fatty acids from fish on premature ventricular complexes and heart rate in humans. Am J Clin Nutr 2005, 81:416–420.

    PubMed  CAS  Google Scholar 

  36. Jouven X, Zureik M, Desnos M, et al.: Resting heart rate as a predictive risk factor for sudden death in middle-aged men. Cardiovasc Res 2001, 50:373–378.

    Article  PubMed  CAS  Google Scholar 

  37. Mozaffarian D, Psaty BM, Rimm EB, et al.: Fish intake and risk for incident atrial fibrillation. Circulation 2004, 110:368–373.

    Article  PubMed  Google Scholar 

  38. Frost L, Vestergaard P: n-3 Fatty acids consumed from fish and risk of atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study. Am J Clin Nutr 2005, 81:50–54.

    PubMed  CAS  Google Scholar 

  39. Calo L, Bianconi L, Colivicchi F, et al.: N-3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a randomized, controlled trial. J Am Coll Cardiol 2005, 45:1723–1728.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Mid America Heart Institute, Saint Luke’s Health System, Lipid and Diabetes Research Center, 4401 Wornall Road, 64111, Kansas City, MO, USA

    William S. Harris PhD

Authors
  1. William S. Harris PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harris, W.S. Extending the cardiovascular benefits of omega-3 fatty acids. Curr Atheroscler Rep 7, 375–380 (2005). https://doi.org/10.1007/s11883-005-0050-0

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11883-005-0050-0

Keywords

Search

Navigation