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The most compelling evidence for the cardiovascular benefit provided by omega-3 fatty acids comes from 3 large controlled trials of 32,000 participants randomized to receive omega-3 fatty acid supplements containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) or to act as controls.
These trials showed reductions in cardiovascular events of 19% to 45%. These findings suggest that intake of omega-3 fatty acids, whether from dietary sources or fish oil supplements, should be increased, especially in those with or at risk for coronary artery disease.
Patients should consume both DHA and EPA. The target DHA and EPA consumption levels are about:
1 gm per day for those with known coronary artery disease and
At least 500 mg per day for those without disease.
Patients with hypertriglyceridemia benefit from treatment with 3 to 4 gm per day of DHA and EPA, a dosage that lowers triglyceride levels by 20% to 50%.
Although 2 meals of oily fish per week can provide 400 to 500 mg per day of DHA and EPA, secondary prevention patients and those with hypertriglyceridemia must use fish oil supplements if they are to reach 1 gm per day and 3 to 4 gm per day of DHA and EPA, respectively.
Combination therapy with omega-3 fatty acids and a statin is a safe and effective way to improve lipid levels and cardiovascular prognosis beyond the benefits provided by statin therapy alone.
Blood DHA and EPA levels could one day be used to identify patients with deficient levels and to individualize therapeutic recommendations.
Source: Mayo Clinic Proceedings, March 2008;83(3):324-332. PMID: 18316000, by John H. Lee, MD, James H. O’Keefe, MD, et al. Mid America Heart Institute and University of Missouri-Kansas City; Ochsner Medical Center, New Orleans, Louisiana; Laboratory of Clinical Epidemiology of Cardiovascular Disease, Italy; Nutrition and Metabolic Disease Research Center, Sanford Research/USD and Sanford School of Medicine of the University of South Dakota, Sioux Falls. [E-mail: email@example.com]