AHA does not recommend omega-3 fish oil supplements to prevent heart disease

An analysis of randomized clinical trials found that the general population should not use omega-3 fish oil supplements to prevent heart disease, according to a science advisory from the American Heart Association (AHA).

The AHA said it was reasonable to use such supplements in patients with prevalent coronary heart disease and recommended using omega-3 fish oil supplements for patients with prevalent heart failure without preserved left ventricular function to reduce mortality and hospitalizations. However, it does not recommend treatment for patients with diabetes mellitus and prediabetes to prevent coronary heart disease.

The AHA also does not recommend omega-3 fish oil supplements to prevent incident stroke in patients at high cardiovascular disease risk and recurrent atrial fibrillation.

The advisory was published online in Circulation on March 13. It focused exclusively on evaluating omega-3 fish oil supplements to prevent cardiovascular diseases and death.

The FDA has approved five prescription omega-3 polyunsaturated fatty acid products to treat severe hypertriglyceridemia. In 2012, 7.8 percent of U.S. adults (approximately 18.8 million people) reported taking fish oil dietary supplement in the past 30 days, according to the authors.

“We cannot make a recommendation to use omega-3 fish oil supplements for primary prevention of cardiovascular disease at this time,” David Siscovick, MD, MPH, chair of the scientific advisory writing committee, said in a news release. “People in the general population who are taking omega-3 fish oil supplements are taking them in the absence of scientific data that shows any benefit of the supplements in preventing heart attacks, stroke, heart failure or death for people who do not have a diagnosis of cardiovascular disease.”

The new scientific advisory updates a 2002 AHA scientific statement. Back then, the authors examined two large randomized controlled trials that found eicosapentaenoic acid and docosahexaenoic acid supplements significantly reduced fatal cardiac events. The AHA at the time recommended additional studies be completed to confirm the findings and define the health benefits of omega-3 fatty acid supplements in preventing cardiovascular disease.

For this scientific advisory, the writing committee evaluated two studies published before 2002 and 13 published since then. None of the trials exclusively targeted the primary prevention of coronary heart disease.

Siscovick said in the news release that omega-3 fish oil supplements could benefit people who had a recent MI, which was the same finding as in 2002. He added that patients with heart failure could also benefit from omega-3 fish oil supplements, which was a new finding from the previous statement.

“Physicians should use this advisory as a guide to make decisions on whether omega-3 fish oil supplements might be appropriate for some patients,” Siscovick said. “The advisory concludes that supplementation with omega-3 fish oil may benefit patients with specific, clinical, cardiovascular disease indications, including patients with a recent prior heart attack and heart failure.”