Omega-3 fatty acids and heart disease
Though omega-3 fatty acids are being applied to a variety of disease states; arguably, the most prominent and extensively investigated is in the area of cardiovascular illness. Such research began in the early 1970s with the discovery that Northern European Eskimos, whose food intake was limited primarily to omega-3 fatty acid rich fatty animal meats and fish, had substantially lower levels of blood lipids and lower rates of heart disease than their European counterparts, who consumed a less fatty, more "balanced" diet 1. Since then, omega-3 fatty acids have been linked to the following salutary cardiovascular effects:
- Hypertriglyceridemia - omega-3 fatty acids are an established and accepted treatment for the severe form of this lipid derangement.
- Sudden cardiac death - though the data are not unanimous, they do suggest that omega-3 fatty acids can inhibit malignant arrhythmias and reduce sudden death risk, especially in the setting of myocardial ischemia 2.
- Atrial fibrillation - preliminary evidence suggests that omega-3 fatty acids reduce the risk of atrial fibrillation in a variety of circumstances, including post coronary bypass grafting and myocardial infarction 3.
- Coronary artery disease - the body of evidence, while not conclusive, has been compelling enough to convince the American Heart Association to recommend fish oil 1g daily for individuals with established heart disease 4
- Congestive Heart Failure - a recent large randomized controlled trial found that fish oil supplementation reduced the risk of death and hospitalization in a population of congestive heart failure patients, possibly through inhibiting ventricular arrhythmias 5.
- Inflammation - via a number of mechanisms, including the upregulation of anti-inflammatory eicosanoid products, a large body of evidence supports the notion that omega-3 fatty acids have useful anti-inflammatory effects 6.
References
- Bang HO, Dyerberg J, Nielsen AB. Plasma lipid and lipoprotein pattern in Greenlandic West-Coast Eskimos. Lancet 1971;1:1143-46.
- London B, Albert C, Anderson ME, Giles WR, Van Wagoner DR, Balk E, Billman GE, Chung M, Lands W, Leaf A, McAnulty J, Martens JR, Costello RB, Lathrop DA. Omega-3 fatty acids and cardiac arrhythmias: prior studies and recommendations for future research: a report from the National Heart, Lung, and Blood Institute and Office Of Dietary Supplements Omega-3 Fatty Acids and their Role in Cardiac Arrhythmogenesis Workshop. Circulation 2007;116(10):e320-35.
- Opthof T, Den Ruijter HM. Omega-3 polyunsaturated fatty acids (PUFAs or fish oils) and atrial fibrillation. Br J Pharmacol 2007;150(3):258-60.
- Kris-Etherton PM, Harris WS, Appel LJ. American Heart Association. Nutrition Committee. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106(21):2747-57.
- Gissi-HF Investigators, Tavazzi L, Maggioni AP, Marchioli R, Barlera S, Franzosi MG, Latini R, Lucci D, Nicolosi GL, Porcu M, Tognoni G. 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 2008;372(9645):1223-30.
- Calder PC. N-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 2006;83(6 Suppl):1505S-19S.
Key Points
- Omega-3 fatty acids may have an important role to play in treating cardiovascular disease.
- A number of cardiovascular endpoints, including atherosclerotic coronary disease, atrial and ventricular arrhythmias, congestive heart failure, and hypertriglyceridemia, may be amenable to omega-3 fatty acid therapy.
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