Effects of omega-3 fatty acids on coronary restenosis, intima-media thickness, and exercise tolerance: a systematic review.
Greater omega-3 fatty acid consumption is associated with reduced cardiovascular disease risk. Though the mechanisms of their effect are unclear, they may involve lesion formation and heart function. We conducted a systematic review of the clinical literature on the effect of omega-3 fatty acids on measures of vascular structure and function. We included studies that assessed fish and plant sources of omega-3 fatty acids on coronary artery restenosis after angioplasty, carotid IMT, and exercise capacity. Compared to placebo, the summary risk ratio of coronary artery restenosis with fish oil is 0.87 (95% CI 0.73, 1.05) across 12 randomized controlled trials. Two prospective studies reported increased carotid IMT, whereas two cross-sectional studies reported a reduction of IMT, with fish, fish oil or ALA consumption. Three randomized trials and three uncontrolled studies reported small non-significant improvements in exercise capacity with fish oil. Overall, little or no effect of fish oil was found for a variety of markers of cardiovascular disease risk. There are insufficient studies to draw conclusions about the effect of ALA. The dearth of long term data on fish consumption or omega-3 fatty acid supplementation on measures of cardiovascular disease risk severely limits our ability to draw definitive conclusions at this time.
Balk
Ethan M
EM
Tufts-New England Medical Center Evidence-based Practice Center, Institute for Clinical Research and Health Policy Studies, 750 Washington Street, NEMC 63, Boston, MA 02111, USA. ebalk@tufts-nemc.org
Lichtenstein
Alice H
AH
Chung
Mei
M
Kupelnick
Bruce
B
Chew
Priscilla
P
Lau
Joseph
J
D002339:Carotid Arteries / Q000000981:diagnostic imaging; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000517:prevention & control*; D005080:Exercise Test; D017079:Exercise Tolerance / Q000187:drug effects / Q000502:physiology*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D006801:Humans; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000187:drug effects; D014463:Ultrasonography
D015525:Fatty Acids, Omega-3