Omega-3 fatty acids reduce the risk of coronary heart disease? The latest research does not think so

Previous studies have found that omega-3 fatty acids can prevent or reduce the development of cardiovascular disease. Some associations and guidelines also recommend increasing the intake of omega-3 fatty acids in the population. However, a meta-analysis published by JAMA Cardiology on January 31 showed that omega-3 fatty acids neither reduced nor increased the risk of fatal or nonfatal coronary heart disease or major vascular events in high-risk patients.

Omega-3 fatty acids reduce the risk of coronary heart disease? The latest research does not think so

The researchers analyzed data from 77,917 patients (mean age 64 years, 61% males) from 10 clinical trials.

The meta-analysis included randomized clinical trials or open randomized controlled trials comparing marine-derived long-chain omega-3 fatty acid supplements with placebo. The trial included at least 500 patients and the treatment time was over 1 year.

Predicted endpoints include death from coronary heart disease, nonfatal myocardial infarction, coronary or non-coronary revascularization events, major vascular events, all-cause death, and stroke with hemorrhagic, ischemic, and difficult-to-classify causes.



The average treatment time was 4.4 years. During the trial, 15.4% of patients had major vascular events, 2.9% had nonfatal myocardial infarction, and 3.5% had coronary heart disease-related death.

The results showed that omega-3 fatty acids had no effect on the incidence of all coronary events (RR = 0.96, 99% CI 0.9-1.01). There were also no effects in the subgroup of coronary heart disease events, including nonfatal myocardial infarction (RR = 0.97, 99% CI 0.87-1.08) and coronary heart disease death (RR = 0.93, 99% CI 0.83-1.03).

The incidence of major vascular events in patients taking omega-3 fatty acids was not affected (RR = 0.97, 95% CI 0.93-1.01).

After multiple test adjustments, omega-3 fatty acids were not associated with the prevalence of major vascular events in the subgroup, including patients with a history of diabetes, a history of coronary heart disease, blood lipid levels above a threshold, and previous treatment with statins.

There was no correlation between omega-3 fatty acids and coronary heart disease death, non-fatal myocardial infarction, or overall coronary heart disease in blinded or open trials. Omega-3 fatty acids were also unrelated to all-cause mortality (RR = 0.96, 95% CI 0.92-1.01).

The 2016 European Society of Cardiology (ESC) and the European Society for Atherosclerosis (EAS) Cardiovascular Disease Prevention Guide point out that the protective effect of omega-3 fatty acids remains to be discussed, and the 2016 guidelines for dyslipidemia indicate that omega-3 The use of fatty acid supplements to prevent the effectiveness of clinical outcomes requires more evidence. The American Heart Association (AHA) recommends that patients with coronary heart disease and heart failure with decreased ejection fraction may be reasonable to prevent coronary heart disease with omega-3 fatty acids. However, the results of this meta-analysis do not recommend the use of omega-3 fatty acids (about 1 g/d) in patients with previous coronary heart disease to prevent lethal CHD, nonfatal myocardial infarction, or any other vascular event. Ongoing trials need to assess whether higher doses of omega-3 fatty acids (3–4 g/d) may have a significant impact on the risk of major vascular events.