Omega-3 fatty acids and cardiovascular disease.
OBJECTIVE
In the last 2 years in the cardiovascular field eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been investigated in terms of their epidemiology and vascular biology, and in large-scale intervention trials, and incorporated into the guidelines of cardiac societies. EPA and DHA have advanced from scientific research into everyday practice, a development reviewed here.


RESULTS
EPA and DHA are antiarrhythmic on the supraventricular and ventricular levels, besides having an anti-atherosclerotic effect. Fish rich in EPA and DHA, contaminated with methyl-mercury, appears less protective. Large-scale clinical trials demonstrated that morbidity can be reduced with EPA even in a population already consuming large amounts of EPA and DHA. Therapy with EPA and DHA can be monitored with the omega-3 index, a risk factor for sudden cardiac death. EPA and DHA appear to be cost-saving in the USA, and, as Omacor, are cost-effective in several European countries.


CONCLUSIONS
European and American Cardiac Societies incorporated EPA and DHA into recent treatment guidelines for myocardial infarction, prevention of cardiovascular disease, treatment of ventricular arrhythmias and prevention of sudden cardiac death. Physicians need to reduce the burden of cardiovascular disease by advocating EPA and DHA to all patients likely to benefit.
von Schacky
Clemens
C
Preventive Cardiology, Medizinische Klinik und Poliklinik Innenstadt, Ludwig Maximilians-Universität München, Münich, Germany. Clemens.vonschacky@med.uni-muenchen.de
D001145:Arrhythmias, Cardiac / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D002319:Cardiovascular System / Q000187:drug effects*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D004281:Docosahexaenoic Acids / Q000627:therapeutic use; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use*; D005395:Fish Oils; D006801:Humans; D018673:Nutrition Policy; D017410:Practice Guidelines as Topic; D012307:Risk Factors
D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid