REVIEW PAPER
Current state-of-the-art knowledge on the role of omega-3 fatty acids in the prevention of cardiovascular disease
1
National Institute of Public Health -National Institute of Hygiene, Warsaw, Poland
2
Institute of Rural Health, Lublin, Poland
Corresponding author
Longina Kłosiewicz-Latoszek
National Institute of Public Health -National Institute of Hygiene, Powsińska, 61/63, 02-903, Warszawa, Poland
National Institute of Public Health -National Institute of Hygiene, Powsińska, 61/63, 02-903, Warszawa, Poland
Ann Agric Environ Med. 2020;27(4):519-525
KEYWORDS
cardiovascular disease preventionomega-3 fatty acidsmechanism of actionclinical trialsmetaanalysesEPAindications
TOPICS
Prevention of occupational diseases in agriculture, forestry, food industry and wood industryState of the health of rural communities depending on various factors: social factors, accessibility of medical care, etc.
ABSTRACT
Introduction:
Polyunsaturated n-3 fatty acid preparations containing eicosapentaenoic acid (EPA) and docosahexanaenoic acid (DHA), or EPA only, have long been recommended in the management of hypertriglyceridaemia, especially when severe (triglyceride levels ≥500 mg/dL), at the dose of 2–4 g/d, mostly for the prevention of acute pancreatitis.
Material and Methods:
The presented article reviews clinical trials and their metaanalyses which evaluated the effect of n-3 fatty acids on cardiovascular disease risk, and regulatory agencies’ and cardiac societies’ positions regarding their use.
Results:
The findings indicate that only EPA is effective. Particular clinical benefit (25% reduction of cardiovascular events) was observed in the recently published REDUCE-IT trial which evaluated EPA (icosapent ethyl) at the dose of 4 g/d for 4.9 years (median), compared to placebo, in hypertriglycerydaemic patients at high or very high cardiovascular risk. This positive effect has been reflected in the expert opinions which recommend eicosapent ethyl (4 g/d) in patients similar to those participating in the REDUCE-IT trial. Additional data in favour of the above position have been provided by the EVAPORATE trial results which showed reduced progression of coronary atherosclerosis with EPA at the dose of 4 g/d.
Conclusions:
The clinical studies and metaanalyses strongly point out that only EPA (icosapent ethyl), especially at dose of 4 g/d, is effective in reducing cardiovascular events in very high and high risk patients with hypertriglyceridemia. The use of EPA + DHA preparations in doses up to 1 g/d does not prevent recurrent cardiovascular events.
Polyunsaturated n-3 fatty acid preparations containing eicosapentaenoic acid (EPA) and docosahexanaenoic acid (DHA), or EPA only, have long been recommended in the management of hypertriglyceridaemia, especially when severe (triglyceride levels ≥500 mg/dL), at the dose of 2–4 g/d, mostly for the prevention of acute pancreatitis.
Material and Methods:
The presented article reviews clinical trials and their metaanalyses which evaluated the effect of n-3 fatty acids on cardiovascular disease risk, and regulatory agencies’ and cardiac societies’ positions regarding their use.
Results:
The findings indicate that only EPA is effective. Particular clinical benefit (25% reduction of cardiovascular events) was observed in the recently published REDUCE-IT trial which evaluated EPA (icosapent ethyl) at the dose of 4 g/d for 4.9 years (median), compared to placebo, in hypertriglycerydaemic patients at high or very high cardiovascular risk. This positive effect has been reflected in the expert opinions which recommend eicosapent ethyl (4 g/d) in patients similar to those participating in the REDUCE-IT trial. Additional data in favour of the above position have been provided by the EVAPORATE trial results which showed reduced progression of coronary atherosclerosis with EPA at the dose of 4 g/d.
Conclusions:
The clinical studies and metaanalyses strongly point out that only EPA (icosapent ethyl), especially at dose of 4 g/d, is effective in reducing cardiovascular events in very high and high risk patients with hypertriglyceridemia. The use of EPA + DHA preparations in doses up to 1 g/d does not prevent recurrent cardiovascular events.
Kłosiewicz-Latoszek L, Cybulska B, Tyszko P. Current state-of-the-art knowledge on the role of omega-3 fatty acids in the prevention of
cardiovascular disease. Ann Agric Environ Med. 2020; 27(4): 519–525. doi: 10.26444/aaem/126674
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