An Update on Omega-3 Polyunsaturated Fatty Acids and Cardiovascular Health

Interest in the potential cardiovascular (CV) benefits of omega-3 polyunsaturated fatty acids (omega-3) began in the 1940s and was amplified by a subsequent landmark trial showing reduced CV disease (CVD) risk following acute myocardial infarction. Since that time, however, much controversy has circulated due to discordant results among several studies and even meta-analyses. Then, in 2018, three more large, randomized trials were released-these too with discordant findings regarding the overall benefits of omega-3 therapy. Interestingly, the trial that used a higher dose (4 g/day highly purified eicosapentaenoic acid (EPA)) found a remarkable, statistically significant reduction in CVD events. It was proposed that insufficient omega-3 dosing (<1 g/day EPA and docosahexaenoic acid (DHA)), as well as patients aggressively treated with multiple other effective medical therapies, may explain the conflicting results of omega-3 therapy in controlled trials. We have thus reviewed the current evidence regarding omega-3 and CV health, put forth potential reasoning for discrepant results in the literature, highlighted critical concepts such as measuring blood levels of omega-3 with a dedicated omega-3 index and addressed current recommendations as suggested by health care professional societies and recent significant scientific data.

Automated summary

Interest in the potential cardiovascular benefits of omega-3 polyunsaturated fatty acids (omega-3) began in the 1940s, but there has been controversy due to conflicting results among studies and meta-analyses. Recent large, randomized trials showed discordant findings, with one using a higher dose of omega-3 showing a significant reduction in cardiovascular events. The conflicting results in clinical trials may be due to inadequate dosing of omega-3 and aggressive treatment with other effective therapies.