title: Omega-3s and cardiovascular health.
abstract: BACKGROUND
  Omega-3 (n-3) fatty acids have previously been shown to reduce the risk of cardiac events, cardiac death, and all-cause mortality in randomized controlled trials. However, recent data have challenged the benefits of n-3 fatty acids in the current era of optimal medical therapy.
  
  
  METHODS
  We performed a literature review indicating important limitations that must be considered when interpreting the recent negative n-3 fatty acids trials.
  
  
  RESULTS
  Our review found relative strengths and weaknesses of both the older and more recent studies, along with many possible explanations for the disparate results. The principal difference between the older and the more recent n-3 studies was a greater use of background optimal medical therapy that may have reduced the benefit from n-3s. Additionally, some of the more recent n-3 trials used relatively low doses or tested n-3 supplementation on top of a relatively high baseline intake of n-3s.
  
  
  CONCLUSIONS
  Despite the recent negative data about n-3 fatty acids, the overall evidence still supports the American Heart Association recommendation of 1 gram of eicosapentaenoic acid/docosahexaenoic acid per day for patients with coronary heart disease.
authors.affiliation: Department of Cardiology, Mid America Heart Institute, Saint Luke's Health System, Kansas City, MO.
authors.forename: James J
authors.initials: JJ
authors.lastname: DiNicolantonio
authors.affiliation: Shifa College of Medicine, Islamabad, Pakistan.
authors.forename: Asfandyar K
authors.initials: AK
authors.lastname: Niazi
authors.affiliation: NutriGuard Research, Inc., Encinitas, CA.
authors.forename: Mark F
authors.initials: MF
authors.lastname: McCarty
authors.affiliation: Mid America Heart Institute, University of Missouri-Kansas City/Saint Luke's Health System, Kansas City, MO.
authors.forename: James H
authors.initials: JH
authors.lastname: O'Keefe
authors.affiliation: The Heart Hospital, University College London Hospital, London, UK and Yale Medical School, New Haven, CT.
authors.forename: Pascal
authors.initials: P
authors.lastname: Meier
authors.affiliation: John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA ; The University of Queensland School of Medicine, Ochsner Clinical School, New Orleans, LA ; Department of Preventive Medicine, Pennington Biomedical Research Center, Baton Rouge, LA.
authors.forename: Carl J
authors.initials: CJ
authors.lastname: Lavie
keywords: Fatty acids–omega-3; fish oils; myocardial infarction