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Long chain omega-3 fatty acids and cardiovascular disease: a systematic review
Javier Delgado-Lista1, Pablo Perez-Martinez, Jose Lopez-Miranda
1Lipids and Atherosclerosis Unit, Department of Medicine, IMIBIC/Hospital Universitario Reina Sofía/Universidad de Cordoba, Cordoba, Spain.
Insights
Marine omega-3 fatty acids significantly reduce cardiovascular events and cardiac death. These fatty acids, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are particularly effective for individuals with high cardiovascular risk.
Area of Science:
- Cardiology
- Nutritional Science
- Preventive Medicine
Background:
- Cardiovascular disease is a leading health concern in developed nations.
- Residual cardiovascular risk persists despite current therapies.
- Marine omega-3 fatty acids (DHA and EPA) are recognized for their potential cardiovascular benefits.
Purpose of the Study:
- To synthesize current evidence on the impact of omega-3 fatty acids on cardiovascular event rates.
- To evaluate the efficacy of omega-3 supplementation in reducing cardiovascular risk.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials.
- Searched MEDLINE and EMBASE databases for studies of omega-3 fatty acids (capsules or dietary) versus placebo or usual diet.
- Included studies with a duration of at least 6 months, focusing on cardiovascular events, cardiac death, coronary events, and all-cause mortality.
Main Results:
- A 10% reduction in the overall risk of cardiovascular events (OR 0.90).
- An 18% decrease in the risk of coronary events (fatal and non-fatal) (OR 0.82).
- A 9% reduction in cardiac death risk (OR 0.91) and a trend towards lower all-cause mortality.
Conclusions:
- Marine omega-3 fatty acids demonstrate effectiveness in preventing cardiovascular events.
- Omega-3 fatty acids are beneficial in reducing cardiac death and coronary events.
- The protective effects are most pronounced in individuals with high cardiovascular risk.
Introduction:
Cardiovascular disease remains the commonest health problem in developed countries, and residual risk after implementing all current therapies is still high. The use of marine omega-3 fatty acids (DHA and EPA) has been recommended to reduce cardiovascular risk by multiple mechanisms.
Objectives:
To update the current evidence on the influence of omega-3 on the rate of cardiovascular events.
Review Methods:
We used the MEDLINE and EMBASE databases to identify clinical trials and randomized controlled trials of omega-3 fatty acids (with quantified quantities) either in capsules or in dietary intake, compared to placebo or usual diet, equal to or longer than 6 months, and written in English. The primary outcome was a cardiovascular event of any kind and secondary outcomes were all-cause mortality, cardiac death and coronary events. We used RevMan 5·1 (Mantel-Haenszel method). Heterogeneity was assessed by the I2 and Chi2 tests. We included 21 of the 452 pre-selected studies.
Results:
We found an overall decrease of risk of suffering a cardiovascular event of any kind of 10 % (OR 0·90; [0·85-0·96], p = 0·001), a 9 % decrease of risk of cardiac death (OR 0·91; [0·83-0·99]; p = 0·03), a decrease of coronary events (fatal and non-fatal) of 18 % (OR 0·82; [0·75-0·90]; p < 1 × 10⁻⁴), and a trend to lower total mortality (5 % reduction of risk; OR 0·95; [0·89-1·02]; p = 0·15. Most of the studies analyzed included persons with high cardiovascular risk.
Conclusions:
marine omega-3 fatty acids are effective in preventing cardiovascular events, cardiac death and coronary events, especially in persons with high cardiovascular risk.
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