![]() Where do we stand?īack to my patients who want to know if they should be taking an omega-3 supplement. No large study has ever evaluated the effects on cardiovascular outcomes of purified DHA alone, leaving us to wonder whether DHA might counteract the benefits of EPA. The STRENGTH trial tested a combination of EPA and DHA. This was similar to the results of another trial, which also found that pure EPA reduced the risk of cardiac events. REDUCE-IT studied a purified formulation of high-dose EPA, which resulted in higher EPA levels. One possibility is that the different results are due to the different drugs studied. We don’t know for certain why the REDUCE-IT trial showed a benefit from omega-3s while the STRENGTH trial did not. The trial was terminated early due to an interim analysis revealing no difference between the two treatment groups. This study enrolled over 13,000 patients who were randomized to receive either the EPA/DHA combination pill or the placebo (a pill filled with corn oil). The STRENGTH trial, published in JAMA, looked at a different formulation of omega-3 fish oil - a combination of EPA and DHA - to see if it would also reduce cardiovascular risk. ![]() STRENGTH trial casts some doubt on omega-3 benefitsīut a recent study has raised some questions. In December 2020, the FDA approved the use of Vascepa to reduce the risk of cardiovascular events in certain patients with, or at high risk for, CVD. Vascepa reduced blood triglyceride levels, but more importantly, it reduced the number of heart attacks and strokes, the need for a heart stenting procedure to open clogged arteries, and death.Ī subsequent meta-analysis, which included data from over 10 studies, found fish oil omega‐3 supplements lowered risk for heart attack and death from coronary heart disease. The results showed a significant benefit of Vascepa over the placebo. They assigned half of the study participants to receive 2 grams of Vascepa twice a day, and assigned the other participants a placebo (a pill filled with mineral oil). This study enrolled over 8,000 patients with elevated cardiovascular risk and high blood triglyceride levels. Vascepa contains purified EPA, and its use is based on good clinical data from the REDUCE-IT trial. Over the past year I have prescribed an omega-3, sold under the brand name Vascepa, to my patients who are at high risk for CVD, based on evidence of cardiovascular benefits. I have written about and been a strong advocate of getting omega-3s through diet, and sometimes through the use of supplements. Omega-3s from fish and fish oil have been recommended by the American Heart Association (AHA) for the past 20 years to reduce cardiovascular events, like heart attack or stroke, in people who already have cardiovascular disease (CVD). Two main omega-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), are found mainly in fish and fish oil. Omega-3 fatty acids show benefit in REDUCE-IT trial and win FDA approval The results of studies looking at omega-3 supplements have been inconsistent, and have left both physicians and patients wondering what to do. Sadly, this remains true of omega-3 fatty acid supplements. This doesn’t mean that a particular patient couldn’t benefit from a specific supplement it just means I don’t have standardized research to guide my recommendations. Often my answer is equivocal, because for most supplements we just don’t have enough evidence to give a definite answer. My patients commonly ask me whether they should try one supplement or another.
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