title: Long chain omega-3 fatty acids and cardiovascular disease: a systematic review.
abstract: BACKGROUND
  Cardiovascular disease remains the commonest health problem in developed countries, and residual risk after implementing all current therapies is still high. The use of marine omega-3 fatty acids (DHA and EPA) has been recommended to reduce cardiovascular risk by multiple mechanisms.
  
  
  OBJECTIVE
  To update the current evidence on the influence of omega-3 on the rate of cardiovascular events.
  
  
  METHODS
  We used the MEDLINE and EMBASE databases to identify clinical trials and randomized controlled trials of omega-3 fatty acids (with quantified quantities) either in capsules or in dietary intake, compared to placebo or usual diet, equal to or longer than 6 months, and written in English. The primary outcome was a cardiovascular event of any kind and secondary outcomes were all-cause mortality, cardiac death and coronary events. We used RevMan 5·1 (Mantel-Haenszel method). Heterogeneity was assessed by the I2 and Chi2 tests. We included 21 of the 452 pre-selected studies.
  
  
  RESULTS
  We found an overall decrease of risk of suffering a cardiovascular event of any kind of 10 % (OR 0·90; [0·85-0·96], p = 0·001), a 9 % decrease of risk of cardiac death (OR 0·91; [0·83-0·99]; p = 0·03), a decrease of coronary events (fatal and non-fatal) of 18 % (OR 0·82; [0·75-0·90]; p < 1 × 10⁻⁴), and a trend to lower total mortality (5 % reduction of risk; OR 0·95; [0·89-1·02]; p = 0·15. Most of the studies analyzed included persons with high cardiovascular risk.
  
  
  CONCLUSIONS
  marine omega-3 fatty acids are effective in preventing cardiovascular events, cardiac death and coronary events, especially in persons with high cardiovascular risk.
authors.affiliation: Lipids and Atherosclerosis Unit, Department of Medicine, IMIBIC/Hospital Universitario Reina Sofía/Universidad de Cordoba, Cordoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Delgado-Lista
authors.forename: Pablo
authors.initials: P
authors.lastname: Perez-Martinez
authors.forename: Jose
authors.initials: J
authors.lastname: Lopez-Miranda
authors.forename: Francisco
authors.initials: F
authors.lastname: Perez-Jimenez
mesh_terms: D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000401:mortality / Q000517:prevention & control*; D003327:Coronary Disease / Q000401:mortality / Q000517:prevention & control; D004032:Diet; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000627:therapeutic use*; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D006801:Humans
chemical_list: D002317:Cardiovascular Agents; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid