Fish oil in the treatment of dyslipidemia.
OBJECTIVE
The recent availability of a concentrated prescription omega-3 fatty acid preparation provides physicians with an additional anti-dyslipidemic agent at a time when limitations of statin therapy in dyslipidemic high-risk patients are recognized. This review examines the evidence supporting the use of omega-3 fatty acid treatment in dyslipidemic states.


RESULTS
There is now considerable evidence that omega-3 fatty acid treatment at the prescription strength of 4 g/day effectively and safely lowers triglyceride levels and increases low-density lipoprotein size, as well as affecting high-density lipoprotein metabolism. Similar effects have been noted in patients treated with statins, and add-on prescription omega-3 fatty acid therapy significantly increases the proportion of statin-treated dyslipidemic patients reaching their non-high-density lipoprotein cholesterol goals. In addition to past studies showing a cardioprotective effect of low-dose omega-3 fatty acid treatment against sudden death, a recent controlled clinical trial showed that 1.8 g of omega-3 fatty acid in statin-treated patients reduced major coronary events by 19% compared with statin plus placebo treatment.


CONCLUSIONS
Omega-3 fatty acid treatment should be considered in patients with severe hypertriglyceridemia as well as in high-risk patients with an atherogenic lipoprotein phenotype.
Goldberg
Ronald B
RB
Division of Endocrinology and Metabolism, University of Miami Miller School of Medicine, Miami, Florida 33136, USA. rgoldber@med.miami.edu
Sabharwal
Anup K
AK
D050197:Atherosclerosis / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy; D050171:Dyslipidemias / Q000188:drug therapy*; D015525:Fatty Acids, Omega-3 / Q000627:therapeutic use; D005395:Fish Oils / Q000627:therapeutic use*; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D008074:Lipoproteins / Q000097:blood / Q000187:drug effects; D008079:Lipoproteins, VLDL / Q000097:blood / Q000187:drug effects
D015525:Fatty Acids, Omega-3; D005395:Fish Oils; D000960:Hypolipidemic Agents; D008074:Lipoproteins; D008079:Lipoproteins, VLDL