[n-3 fatty acids and cardiovascular diseases: update to 1996]

n-3 Fatty acids (mostly eicosapentaenoic and docosahexaenoic acid) continue to elicit research interest as dietary or pharmacological agents able to prevent or retard the progression of atherosclerosis and its clinical manifestations. Significant advances have occurred over the past five years in understanding their mechanism of action, including anti-atherogenic, anti-thrombotic and anti-arrhythmic properties. In parallel, clinical studies have continued the evaluation of these compounds in the prevention of cardiovascular disease. Recent epidemiological studies have in general confirmed the hypothesis of a relevant anti-atherogenic effect, although this has not necessarily translated into clinical benefits in selected, relatively low-risk populations. Recent negative studies in trials of restenosis prevention after coronary angioplasty have tempered the initial enthusiasm as a possible preventive strategy in this subset, although reasons for discrepancies among past trials still await conclusive explanations. A recent dietary intervention trial in post-myocardial infarction patients has renewed the interest for alpha-linolenic acid, both as the metabolic precursor of eicosapentaenoic and docosahexaenoic acid, and as a fatty acid with direct specific properties.