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The Triglyceride-Lowering Effects of a Modest Dose of Docosahexaenoic Acid Alone Versus in Combination with Low Dose Eicosapentaenoic Acid in Patients with Coronary Artery Disease and Elevated Triglycerides

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By Lisa J. Schwellenbach, et al. • • February 14, 2007

[Note: elevated triglycerides are a risk factor for coronary artery disease, which involves thickening or ‘hardening’ of the arteries supplying blood to the heart muscle. Docosahexaenoic acid or DHA and eicosapentaenoic acid or EPA are essential omega-3 fatty acids most often found in fish oil.]

Journal: Journal of the American College of Nutrition. 2006. Vol. 25, No. 6, 480-485

Authors and affiliations: Lisa J. Schwellenbach, Kari L. Olson, Karen J. McConnell, Ryan S. Stolcpart, James D. Nash, John A. Merenich. Kaiser Permanente Colorado Clinical Pharmacy Cardiac Risk Service; School of Pharmacy at Denver Health Sciences Center; Colorado Permanente Medical Group; University of Colorado Health Sciences Center, Denver; Clinical Pharmacy Programs, Humana Inc., Louisville, Kentucky. [E-mail: Kari L. Olson, PharmD, BCPS, ]

Background: Hypertriglyceridemia is a risk factor for coronary artery disease (CAD). The American Heart Association recommends 1000 mg of omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), daily for cardioprotection and higher doses for triglyceride-lowering in patients with CAD.

Methods: This was a prospective, randomized, double-blind study comparing DHA to DHA + EPA in patients with CAD and triglycerides greater than 200 mg/dL.

Subjects were randomized to either 1000 mg of DHA or 1252 mg of DHA + EPA for eight weeks. Baseline and eight-week laboratories were drawn to assess changes in the fasting lipid profile. The primary objective was to evaluate the change in triglycerides between the two groups at eight weeks.

Results: A total of 116 subjects were enrolled; 57 in the DHA group and 59 in the DHA + EPA group. Baseline characteristics were similar between groups. The mean age was 69.4 ± 9.1 years and 70.7% were male.

Triglycerides decreased by an average of 21.8% in the DHA group (p < 0.001) and 18.3% in the DHA + EPA group (p < 0.001). The difference between groups was not significant.

A greater proportion of subjects in the DHA group achieved triglyceride goal (less than 150 mg/dL) compared to the DHA + EPA group (24.6% versus 10.2%, p < 0.05).

Conclusions: Our results indicate that:

n The American Heart Association recommended cardioprotective dose of omega-3 fatty acids can also significantly lower triglycerides in patients with CAD.

n There do not appear to be significant differences in triglyceride-lowering between DHA only and DHA + EPA combination products when dosing is based on DHA. Keywords: coronary artery disease, hypertriglyceridemia, omega-3 fatty acids

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