Skip to main content
×
Home
    • Aa
    • Aa

Long chain omega-3 fatty acids and cardiovascular disease: a systematic review

  • Javier Delgado-Lista (a1) (a2), Pablo Perez-Martinez (a1) (a2), Jose Lopez-Miranda (a1) (a2) and Francisco Perez-Jimenez (a1) (a2)
Abstract

Introduction: Cardiovascular disease remains the commonest health problem in developed countries, and residual risk after implementing all current therapies is still high. The use of marine omega-3 fatty acids (DHA and EPA) has been recommended to reduce cardiovascular risk by multiple mechanisms. Objectives: To update the current evidence on the influence of omega-3 on the rate of cardiovascular events. Review Methods: We used the MEDLINE and EMBASE databases to identify clinical trials and randomized controlled trials of omega-3 fatty acids (with quantified quantities) either in capsules or in dietary intake, compared to placebo or usual diet, equal to or longer than 6 months, and written in English. The primary outcome was a cardiovascular event of any kind and secondary outcomes were all-cause mortality, cardiac death and coronary events. We used RevMan 5·1 (Mantel-Haenszel method). Heterogeneity was assessed by the I2 and Chi2 tests. We included 21 of the 452 pre-selected studies. Results: We found an overall decrease of risk of suffering a cardiovascular event of any kind of 10 % (OR 0·90; [0·85–0·96], p = 0·001), a 9 % decrease of risk of cardiac death (OR 0·91; [0·83–0·99]; p = 0·03), a decrease of coronary events (fatal and non-fatal) of 18 % (OR 0·82; [0·75–0·90]; p < 1 × 10− 4), and a trend to lower total mortality (5 % reduction of risk; OR 0·95; [0·89–1·02]; p = 0·15. Most of the studies analyzed included persons with high cardiovascular risk. Conclusions: marine omega-3 fatty acids are effective in preventing cardiovascular events, cardiac death and coronary events, especially in persons with high cardiovascular risk.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Long chain omega-3 fatty acids and cardiovascular disease: a systematic review
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Long chain omega-3 fatty acids and cardiovascular disease: a systematic review
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Long chain omega-3 fatty acids and cardiovascular disease: a systematic review
      Available formats
      ×
Copyright
Corresponding author
*Corresponding author: F. Perez-Jimenez, fax +34 957 204763, email fperezjimenez@uco.es
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

2AH Lichtenstein , LJ Appel , M Brands , (2006) Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation 114, 8296.

3CJ Lavie , RV Milani , MR Mehra , (2009) Omega-3 polyunsaturated fatty acids and cardiovascular diseases. J Am Coll Cardiol 54, 585594.

5ND Riediger , RA Othman , M Suh , (2009) A systemic review of the roles of n-3 fatty acids in health and disease. J Am Diet Assoc 109, 668679.

6KB Filion , F El Khoury , M Bielinski , (2010) Omega-3 fatty acids in high-risk cardiovascular patients: a meta-analysis of randomized controlled trials. BMC Cardiovasc Disord 10, 24.

7AR Jadad , RA Moore , D Carroll , (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17, 112.

8GJ Dehmer , JJ Popma , EK van den Berg , (1988) Reduction in the rate of early restenosis after coronary angioplasty by a diet supplemented with n-3 fatty acids. N Engl J Med 319, 733740.

9ER Nye , MB Ablett , MC Robertson , (1990) Effect of eicosapentaenoic acid on restenosis rate, clinical course and blood lipids in patients after percutaneous transluminal coronary angioplasty. Aust N Z J Med 20, 549552.

10I Bairati , L Roy & F Meyer (1992) Double-blind, randomized, controlled trial of fish oil supplements in prevention of recurrence of stenosis after coronary angioplasty. Circulation 85, 950956.

11A Leaf , MB Jorgensen , AK Jacobs , (1994) Do fish oils prevent restenosis after coronary angioplasty? Circulation 90, 22482257.

13J Eritsland , H Arnesen , K Gronseth , (1996) Effect of dietary supplementation with n-3 fatty acids on coronary artery bypass graft patency. Am J Cardiol 77, 3136.

16O Johansen , M Brekke , I Seljeflot , (1999) N-3 fatty acids do not prevent restenosis after coronary angioplasty: results from the CART study. Coronary Angioplasty Restenosis Trial. J Am Coll Cardiol 33, 16191626.

19ML Burr , PA Ashfield-Watt , FD Dunstan , (2003) Lack of benefit of dietary advice to men with angina: results of a controlled trial. Eur J Clin Nutr 57, 193200.

20A Leaf , CM Albert , M Josephson , (2005) Prevention of fatal arrhythmias in high-risk subjects by fish oil n-3 fatty acid intake. Circulation 112, 27622768.

21MH Raitt , WE Connor , C Morris , (2005) Fish oil supplementation and risk of ventricular tachycardia and ventricular fibrillation in patients with implantable defibrillators: a randomized controlled trial. JAMA 293, 28842891.

22IA Brouwer , PL Zock , AJ Camm , (2006) 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 295, 26132619.

24HFI Gissi , L Tavazzi , AP Maggioni , (2008) Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomised, double-blind, placebo-controlled trial. Lancet 372, 12231230.

28S Nodari , M Triggiani , U Campia , (2011) Effects of n-3 polyunsaturated fatty acids on left ventricular function and functional capacity in patients with dilated cardiomyopathy. J Am Coll Cardiol 57, 870879.

30C von Schacky & WS Harris (2007) Cardiovascular benefits of omega-3 fatty acids. Cardiovasc Res 73, 310315.

32PE Marik & J Varon (2009) Omega-3 dietary supplements and the risk of cardiovascular events: a systematic review. Clin Cardiol 32, 365372.

33P Saravanan , NC Davidson , EB Schmidt , (2010) Cardiovascular effects of marine omega-3 fatty acids. Lancet 376, 540550.

36C White (2005) Suspected research fraud: difficulties of getting at the truth. BMJ 331, 281288.

37H Iso , M Kobayashi , J Ishihara , (2006) Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based (JPHC) Study Cohort I. Circulation 113, 195202.

38N Watanabe , Y Watanabe , M Kumagai , (2009) Administration of dietary fish oil capsules in healthy middle-aged Japanese men with a high level of fish consumption. Int J Food Sci Nutr 60, Suppl. 5, 136142.

39H Origasa , M Yokoyama , M Matsuzaki , (2010) Clinical importance of adherence to treatment with eicosapentaenoic acid by patients with hypercholesterolemia. Circ J 74, 510517.

41P Perez-Martinez , J Delgado-Lista , F Perez-Jimenez , (2010) Update on genetics of postprandial lipemia. Atheroscler Suppl 11, 3943.

42TM Teslovich , K Musunuru , AV Smith , (2010) Biological, clinical and population relevance of 95 loci for blood lipids. Nature 466, 707713.

43H Pishva , SA Mahboob , P Mehdipour , (2010) Fatty acid-binding protein-2 genotype influences lipid and lipoprotein response to eicosapentaenoic acid supplementation in hypertriglyceridemic subjects. Nutrition 26, 11171121.

44E Olano-Martin , E Anil , MJ Caslake , (2010) Contribution of apolipoprotein E genotype and docosahexaenoic acid to the LDL-cholesterol response to fish oil. Atherosclerosis 209, 104110.

47F Thies , JM Garry , P Yaqoob , (2003) Association of n-3 polyunsaturated fatty acids with stability of atherosclerotic plaques: a randomised controlled trial. Lancet 361, 477485.

48WS Harris , M Miller , AP Tighe , (2008) Omega-3 fatty acids and coronary heart disease risk: clinical and mechanistic perspectives. Atherosclerosis 197, 1224.

49CN Serhan , N Chiang & TE Van Dyke (2008) Resolving inflammation: dual anti-inflammatory and pro-resolution lipid mediators. Nat Rev Immunol 8, 349361.

52D Mozaffarian , BM Psaty , EB Rimm , (2004) Fish intake and risk of incident atrial fibrillation. Circulation 110, 368373.

54P Saravanan , B Bridgewater , AL West , (2010) Omega-3 fatty acid supplementation does not reduce risk of atrial fibrillation after coronary artery bypass surgery: a randomized, double-blind, placebo-controlled clinical trial. Circ Arrhythm Electrophysiol 3, 4653.

55IA Brouwer , MH Raitt , C Dullemeijer , (2009) Effect of fish oil on ventricular tachyarrhythmia in three studies in patients with implantable cardioverter defibrillators. Eur Heart J 30, 820826.

56AO Verkerk , AC van Ginneken , G Berecki , (2006) Incorporated sarcolemmal fish oil fatty acids shorten pig ventricular action potentials. Cardiovasc Res 70, 509520.

57R Coronel , FJ Wilms-Schopman , HM Den Ruijter , (2007) Dietary n-3 fatty acids promote arrhythmias during acute regional myocardial ischemia in isolated pig hearts. Cardiovasc Res 73, 386394.

59S Chalupka (2009) Omega-3 polyunsaturated fatty acid in primary and secondary cardiovascular disease prevention. AAOHN J 57, 480.

61SD Kristensen , AM Iversen & EB Schmidt (2001) n-3 polyunsaturated fatty acids and coronary thrombosis. Lipids 36, S79S82.

63PD Watson , PS Joy , C Nkonde , (2009) Comparison of bleeding complications with omega-3 fatty acids+aspirin+clopidogrel–versus–aspirin+clopidogrel in patients with cardiovascular disease. Am J Cardiol 104, 10521054.

64K Park & D Mozaffarian (2010) Omega-3 fatty acids, mercury, and selenium in fish and the risk of cardiovascular diseases. Curr Atheroscler Rep 12, 414422.

66MF Hau , AH Smelt , AJ Bindels , (1996) Effects of fish oil on oxidation resistance of VLDL in hypertriglyceridemic patients. Arterioscler Thromb Vasc Biol 16, 11971202.

73GC Leng , GS Taylor , AJ Lee , (1999) Essential fatty acids and cardiovascular disease: the Edinburgh Artery Study. Vasc Med 4, 219226.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

British Journal of Nutrition
  • ISSN: 0007-1145
  • EISSN: 1475-2662
  • URL: /core/journals/british-journal-of-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords:

Metrics

Altmetric attention score