title: Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association.
abstract: Multiple randomized controlled trials (RCTs) have assessed the effects of supplementation with eicosapentaenoic acid plus docosahexaenoic acid (omega-3 polyunsaturated fatty acids, commonly called fish oils) on the occurrence of clinical cardiovascular diseases. Although the effects of supplementation for the primary prevention of clinical cardiovascular events in the general population have not been examined, RCTs have assessed the role of supplementation in secondary prevention among patients with diabetes mellitus and prediabetes, patients at high risk of cardiovascular disease, and those with prevalent coronary heart disease. In this scientific advisory, we take a clinical approach and focus on common indications for omega-3 polyunsaturated fatty acid supplements related to the prevention of clinical cardiovascular events. We limited the scope of our review to large RCTs of supplementation with major clinical cardiovascular disease end points; meta-analyses were considered secondarily. We discuss the features of available RCTs and provide the rationale for our recommendations. We then use existing American Heart Association criteria to assess the strength of the recommendation and the level of evidence. On the basis of our review of the cumulative evidence from RCTs designed to assess the effect of omega-3 polyunsaturated fatty acid supplementation on clinical cardiovascular events, we update prior recommendations for patients with prevalent coronary heart disease, and we offer recommendations, when data are available, for patients with other clinical indications, including patients with diabetes mellitus and prediabetes and those with high risk of cardiovascular disease, stroke, heart failure, and atrial fibrillation.
authors.forename: David S
authors.initials: DS
authors.lastname: Siscovick
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Barringer
authors.forename: Amanda M
authors.initials: AM
authors.lastname: Fretts
authors.forename: Jason H Y
authors.initials: JH
authors.lastname: Wu
authors.forename: Alice H
authors.initials: AH
authors.lastname: Lichtenstein
authors.forename: Rebecca B
authors.initials: RB
authors.lastname: Costello
authors.forename: Penny M
authors.initials: PM
authors.lastname: Kris-Etherton
authors.forename: Terry A
authors.initials: TA
authors.lastname: Jacobson
authors.forename: Mary B
authors.initials: MB
authors.lastname: Engler
authors.forename: Heather M
authors.initials: HM
authors.lastname: Alger
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
authors.forename: Dariush
authors.initials: D
authors.lastname: Mozaffarian
mesh_terms: D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000517:prevention & control; D019587:Dietary Supplements; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005395:Fish Oils / Q000008:administration & dosage*; D006333:Heart Failure / Q000517:prevention & control; D006801:Humans; D011322:Primary Prevention; D012306:Risk; D055502:Secondary Prevention; D020521:Stroke / Q000517:prevention & control
chemical_list: D015525:Fatty Acids, Omega-3; D005395:Fish Oils
keywords: AHA Scientific Statements; cardiovascular disease; fatty acids, omega-3; fish oils; prevention and control; randomized controlled trials