Many people take fish oil supplements based on claims that they boost heart health. Data collected by the National Health Interview Survey, as part of its research, showed that the number is more than 8 million adults in the U.S.
An article published in The New England Journal of Medicine in May 2013 showed that evidence that it actually works has been mixed. But a new clinical trial shows that a type of omega-3 fatty acid found in fish oil may reduce the chances of major cardiovascular events in high-risk patients.
Recently, Amarin, the biopharmaceutical company announced that the results of early research indicating that its prescription fish oil medication called Vascepa may lower the rate of stroke, heart attack and other cardiovascular events by 25% in patients with type 2 diabetes or heart disease who are already taking statin to lower cholesterol levels.
The study investigator Robert Busch, MD, who is an endocrinologist and director of clinical research at Albany Medical College New York says, “Having a drug that lower cardiac events in patients who are already on statin with LDL levels (bad cholesterol) already at goal is an incredible, game-changing breakthrough, particularly for someone who has diabetes or heart disease with multiple risk factors.”
“It changes what we do. Even today walking in exam rooms, I prescribed the drug when I hadn’t before because of these outcomes.”
Vascpea reduce risk of cardiac events in people already at elevated risk by 25%
For about 5 years, investigators followed 8,179 patients with elevated cardiovascular risk who are already taking stating to control their bad cholesterol levels. Their median baseline LDL (low-density lipoprotein) cholesterol levels were at a healthy 75 mg/dL (milligram/decilitre).
According to the Cleveland Clinic, an LDL measure less than 100 is considered optimal. High LDL levels can cause the arteries to clog, which raise the risk of stroke and heart attack.
Yet, trial participants did have consistently high levels of the most common fat in the body called triglycerides. According to the American Heart Association, high triglyceride levels have also been linked to heart disease. In this study, the median baseline for patient triglyceride was 216 mg/dL, whereas the healthy level is not up to 150 mg/dL.
Half of the participants receive a 4-gram capsule of the fish oil supplement called Vascepa each day while the other half received a placebo each day. At the end of the trial period, the group taking Vascepa had an approximately 25% lower risk of major cardiac events like coronary revascularization, nonfatal stroke, heart attack, cardiovascular death, or hospitalization from unstable angina (the condition where the heart does not get enough oxygen and blood flow) – compared with those taking the placebo.
Promising results, but they are yet to be published, so questions remain
A cardiologist with Baylor Regional Medical Center in Plano, Texas, Sarah Samaan, MD, notes that while results look “extremely promising,” the study is not yet published officially, and lots of specifics are not known yet.
Dr. Samaan. Who wasn’t involved in the research says, “For example, Vascepa is currently used and the Food and Drug Administration (FDA) – approved to lower triglycerides.” “Was the benefit due to the effect on triglycerides or something else entirely?”
She says it is not possible to identify who will specifically benefit from Vascepa, other than people who are already taking it for high triglycerides.
She also stresses that whether the effects will translate into benefits for people that are not already on statins remains to be seen.
Not all fish oil drugs and supplements are the same
One important point to know is that Vascepa is a prescription medication. This findings conclusion does not mean all fish oil supplements and drugs can do the same work.
Vascepa contains just icosapent ethyl, which is a form of omega-3 fatty acid known as eicosapentaenoic acid (EPA). Other over-the-counter fish oil products and prescription fish oil drugs like Lovaza, contain EPA and docosahexaenoic acid (DHA), which is another type of omega-3 fatty acid.
Vascepa doesn’t raise LDL, but fish oil with DHA component intact tends to raise LDL, especially in those who start out high triglycerides.
Craig Granowitz, MD, senior vice president and chief medical officer of Amarin in his statement remarked that the results of this research couldn’t be generalized to apply to fish oil products containing DHA.
The bottom line
The findings of this study will probably not provide any rationale for taking over-the-counter fish oil or other forms of omega-3 acid supplements. While fish oil has been controversial, the results of this investigation are really decisive.
Many studies in medicine have really changed what we do every day, and this is one of them.