Research from Harvard presents a critical meta-analysis on omega-3 fatty acids and cardiovascular diseases. This study scrutinizes data from 13 trials, including three significant 2018 studies: ASCEND, VITAL, and REDUCE-IT. Incorporating these three studies expanded the sample size by 64%, enhancing the total population size to nearly 130,000 participants.
Researchers were particularly interested in the incidence of heart attacks, coronary heart disease (CHD) death, total CHD, total stroke, cardiovascular disease (CVD) death, total CVD, and major vascular events. Over an average treatment duration of 5 years, there were 3,838 heart attacks, 3,008 CHD deaths, 8,435 total CHD events, 2,683 strokes, 5,017 CVD deaths, 15,759 total CVD events, and 16,478 major vascular events.
Excluding the REDUCE-IT study, omega-3 supplementation versus placebo was linked with a significantly lower risk of heart attack, CHD death, total CHD, CVD death, and total CVD.
The addition of REDUCE-IT introduced significant heterogeneity but also reinforced the inverse associations for all outcomes. There were statistically significant linear dose-response relationships for total CVD and major vascular events both with and without REDUCE-IT. However, no impact was observed on stroke incidence.
The findings suggest a linear relationship between omega-3 dosage and cardiovascular benefits, indicating greater benefits at higher doses. The researchers advocate for more extensive trials testing high doses of omega-3 supplements to confirm and extend these findings.
Overview of the 2018 Omega-3 Studies – ASCEND, REDUCE-IT, VITAL
ASCEND
The ASCEND study failed to demonstrate any benefit of omega-3 and aspirin for heart disease among diabetics. It recruited over 15,000 UK individuals, aiming to determine if 100 mg aspirin and/or 840 mg omega-3 fatty acids daily reduces the risk of cardiovascular events or cancer. The omega-3 portion used a 1-gram daily prescription omega-3 product containing 840 mg EPA+DHA. The study concluded that omega-3 supplementation does not reduce the risk of cardiovascular events in patients with diabetes.
REDUCE-IT
REDUCE-IT focused on the omega-3 fatty acid EPA in ethyl ester form, using the drug Vascepa. It followed over 8,000 adults at high risk for cardiovascular disease, showing a 25% relative risk reduction in the primary endpoint for serious cardiovascular events among those taking 2 grams of Vascepa twice daily.
VITAL
VITAL studied over 25,000 individuals to assess whether 1 gram of fish oil (providing 840 mg EPA+DHA) or 2000 IU of vitamin D3 could prevent cancer, heart disease, and stroke in previously healthy people. Despite not achieving its primary outcomes for preventing significant cardiovascular events, VITAL showed statistically significant benefits, including a 28% reduction in heart attacks among those taking omega-3 supplements.
The importance of dosage
The results from these studies highlight the significance of omega-3 dosage in reducing cardiovascular issues. With VITAL participants taking less than 1 gram of EPA and DHA, and REDUCE-IT participants taking 4 grams of EPA, the modest results of VITAL contrast with the dramatic outcomes of REDUCE-IT, underscoring the potential for greater benefits at higher doses.
Dr. Bill Harris, a prominent omega-3 researcher, suggests that the beneficial results in REDUCE-IT were likely due to the dosage achieving a near or above optimal Omega-3 Index of 8%, a target not met in trials with lower doses. This points to the necessity of higher omega-3 doses to significantly reduce the risk of cardiovascular diseases.
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