The American Heart Association (AHA) has come out with new recommendations for the role of omega-3 supplements in preventing cardiovascular disease (CVD). In an updated scientific advisory published yesterday, March 13, in the AHA journal Circulation1, the advisory authors state that omega-3 fish oil supplements can assist with secondary prevention of coronary heart disease (CHD) and sudden cardiac death in patients with prevalent CHD and in patients with heart failure. This recommendation is a positive update to a previous AHA scientific recommendation2 the association published back in 2002. In that review, the authors cautioned that “additional studies are needed to confirm and further define the health benefits of omega-3 fatty acid supplements for both primary and secondary prevention.”
In the new review, the authors gear their recommendations for supplementation toward those with diagnosed CHD, not the general public: “Although recent RCT [randomized controlled trial] evidence has raised questions about the benefits of omega-3 supplementation to prevent clinical CVD events, the recommendation for patients with prevalent CHD such as a recent [myocardial infarction] remains essentially unchanged: Treatment with omega-3 PUFA supplements is reasonable for these patients. Even a potential modest reduction in CHD mortality (10%) in this clinical population would justify treatment with a relatively safe therapy. We now recommend treatment for patients with prevalent heart failure without preserved left ventricular function to reduce mortality and hospitalizations (9%) on the basis of a single, large RCT.”
GOED, the Global Organization for EPA and DHA Omega-3s (Salt Lake City, UT), called news of the updated recommendations positive for the omega-3 industry.
The AHA declined to make any recommendations for omega-3 supplements for primary prevention of coronary heart disease, however, stating that strong enough evidence for such a recommendation is not yet available. “Because there are no reported RCTs related to the primary prevention of CHD, heart failure, and [atrial fibrillation, or AF], we were not able to make recommendations for these indications,” the authors wrote. They also did not recommend omega-3 treatment to prevent incidents of stroke among patients with high CVD risk and AF.
In making their recommendations, the scientific review authors evaluated large RCTs involving omega-3 supplementation and end points of major clinical cardiovascular disease, plus meta-analyses on such RCTs. Their recommendations are geared toward clinicians and patients.
- Siscovick DS et al., “Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association, Circulation. Published online March 13, 2017.
- Kris-Etherton PM et al., “Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease,” Circulation, vol. 106, no. 21 (November 19, 2002): 2747-2757