Mayo Clinic Proceedings February 2021; Vol. 96; No. 2; pp. 304-313

Aldo A. Bernasconi, PhD; Michelle M. Wiest, PhD; Carl J. Lavie, MD; Richard V. Milani, MD; Jari A. Laukkanen, MD, PhD: from the University of Idaho; the University of Queensland School of Medicine, New Orleans; and the University of Eastern Finland. This study cites 28 references.

Cardiovascular disease (CVD) continues to be the leading cause of death globally, despite significant strides in prevention and treatment. In the United States alone, heart disease accounted for 23% of all deaths in 2017, emphasizing the urgent need for effective strategies to mitigate CVD risks.

A recent meta-analysis, focusing on the impact of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, two vital omega-3 long-chain polyunsaturated fatty acids found in marine sources, sheds light on their potential in CVD prevention. The study, encompassing 40 randomized control trials with 135,267 participants, aimed to quantify the effect of EPA/DHA supplementation on various CVD outcomes.

The outcomes, including myocardial infarction (MI), coronary heart disease (CHD) events, CHD mortality, and fatal MI, were assessed across a spectrum of dosages ranging from 400 mg/day to 5,500 mg/day, with an average daily dose of 1,221 mg of EPA + DHA.

Key findings from the meta-analysis highlight the efficacy of EPA + DHA supplementation in reducing the risk of adverse CVD outcomes. The combined results unequivocally demonstrate a significant risk reduction in CHD events and MI, with a 9% lower risk of CHD and a 13% lower risk of MI associated with the use of EPA + DHA. Importantly, the protective effect of these fatty acids appears to increase with dosage, emphasizing the dose-dependent nature of their impact.

The study’s key point underscores a 35% reduction in the risk of fatal MI and a 9% reduction in CHD mortality with EPA + DHA supplementation. This not only establishes the effectiveness of long-chain marine omega-3s in preventing CHD events but also highlights their specific protective role against MI.

Crucially, the meta-analysis advocates for the consideration of these results by authoritative bodies, issuing intake recommendations, and healthcare providers. The cost-effectiveness and minimal side effect profiles of omega-3 supplementation, especially in the 1000 to 2000 mg/day range, make it a compelling strategy for primary and secondary CVD prevention.

The study concludes by emphasizing the rarity and generally non-serious nature of side effects associated with omega-3 supplementation. Clinicians and patients are encouraged to explore the potential benefits of incorporating EPA and DHA into their daily routine, particularly through supplementation in dosages that are often not achieved through Westernized diets, even those including routine fish consumption.

In conclusion, this comprehensive meta-analysis provides robust evidence supporting the role of EPA and DHA in cardiovascular health, urging a reevaluation of dietary and supplementation practices to enhance CVD prevention strategies.