Cardiovascular disease prevention and treatment.
The incidence of fatal and non-fatal cardiovascular disease (sudden cardiac death (SCD), myocardial infarction, others) varies, depending on conventional risk factors. However, in Western countries, like the US or Germany, incidences of fatal and non-fatal cardiovascular disease are far higher than in countries like Japan. In the present article, these differences are discussed and related to eicosapentaenoic acid (C20:5omega-3 or C20:5n-3; EPA) and docosahexaenoic acid (C22:6omega-3; DHA). Dietary intake of EPA and DHA and a number of other factors determine levels of EPA and DHA in an individual--best assessed as the omega-3 index, defined as the percentage of EPA and DHA in red cells, and analyzed in a standardized fashion. A review of the literature, expanded by measurements of the omega-3 index, indicates that the risk of sudden cardiac death correlates inversely with the omega-3 index. For persons with an omega-3 index <4%, risk is tenfold, as compared to persons with an omega-3 index >8%. A similar, less-pronounced, correlation exists for non-fatal cardiovascular disease. EPA and DHA have anti-arrhythmic and anti-atherosclerotic mechanisms of action. In large-scale intervention studies, intake of EPA and DHA has been demonstrated to reduce SCD and non-fatal cardiovascular events. Assessing or recommending dietary intake of EPA and DHA does not predict the resulting omega-3 index. Taken together, the omega-3 index is a biomarker to assess a person's content of omega-3 fatty acids, and thus the risk for sudden cardiac death, as well as non-fatal cardiovascular events. EPA and DHA prevent fatal and non-fatal cardiovascular disease and complications of congestive heart failure.
von Schacky
Clemens
C
Preventive Cardiology, Medizinische Clinic and Policlinic Innenstadt, University of Munich, Ziemssensstr. 1, D-80336 Munich, Germany. clemens.vonschacky@med.uni-muenchen.de
D001145:Arrhythmias, Cardiac / Q000517:prevention & control; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000517:prevention & control*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology / Q000517:prevention & control*; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D004912:Erythrocytes / Q000187:drug effects; D005060:Europe / Q000453:epidemiology; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D009203:Myocardial Infarction / Q000517:prevention & control; D011247:Pregnancy; D012306:Risk; D014481:United States / Q000453:epidemiology
D015415:Biomarkers; D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid