Fish, fish oil may lower risk of heart attack
EATING more fish or taking a fish oil supplement can reduce your risk of a heart attack, according to a pair of Harvard-led clinical trials. Heart benefits from omega-3 fatty acids were found both in healthy people and in people with conditions that put them at increased risk of heart attack, stroke or heart disease, the two studies found. The Vitamin D and Omega-3 Trial (VITAL) found that healthy people who took a fish oil supplement suffered fewer heart attacks, particularly if they were black or did not regularly eat fish. Meanwhile, a purified form of omega-3 fatty acid reduced the risk of death by heart disease, heart attack or stroke in people with hardened arteries or other heart risk factors, according to findings from the Reduction of Cardiovascular Events with Icosapent Ethyl Intervention Trial (REDUCE-IT). The two studies provide firm evidence that the omega 3 fatty acids found in fish like salmon, sardines or tuna can have a beneficial effect on heart health, said Dr JoAnn Manson, chief of preventive medicine at Brigham and Women’s Hospital in Boston, and lead researcher for the VITAL trial. “We’re not recommending that everyone in the world begin taking fish oil supplements. In terms of the omega 3s, the best thing to do is to try to have more dietary fish,” Manson said. “If people aren’t going to eat fish, there really may be some benefits from taking a fish oil supplement. We recommend they discuss that with their health care provider.” For the VITAL trial, nearly 26,000 US men and women aged 50 and older were randomly assigned to take one gram of fish oil or 2,000 International Units of vitamin D daily, or a placebo. Participants had no history of heart problems. The fish oil supplements reduced risk of heart attack by 28 per cent over a five-year follow-up period, but they did not affect a person’s risk of stroke or cancer, researchers found. “The lower risk of heart attack was found particularly in those who have low fish consumption,” Manson said. “That group had 19 per cent reduction in all major cardiovascular events, plus they had a 40 per cent reduction in heart attack.” VITAL also found overwhelming benefit of fish oil supplements for black participants, who had a 77 per cent reduction in their risk of heart attack. “If that can be confirmed in a follow-up study, then it could point to a very promising approach to reducing a health disparity,” Manson said. Dr Satjit Bhusri is a cardiologist with Lenox Hill Hospital in New York City. “This is a very important and impressive trial. Its results will have a lasting change in the prevention of heart disease,” said Bhusri, who was not involved with the studies. “A reduction in heart attacks this profound has not seen been since in primary prevention since the early trials of aspirin therapy.” REDUCE-IT included more than 8,000 patients taking statins to lower their cholesterol and prevent either a first or repeat heart attack or stroke. About seven in 10 patients in the study had hardened arteries, while the rest had diabetes and at least one other heart risk factor. People taking icosapent ethyl had a 20 per cent reduction in their risk of heartrelated death, a 31 per cent reduction in heart attack and a 28 per cent reduction in stroke, compared to those given a placebo, researchers found.
If people aren’t going to eat fish, there really may be some benefits from taking a fish oil supplement. We recommend they discuss that with their health care provider.