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Omega-3 Fatty Acids Linked with Lower Sudden Death and CHD Risks

Eating more fish may help to prevent some types of adverse heart events.

Prior research has touted the benefits of a diet rich in fish oil to reduce risks for coronary heart disease (CHD) and sudden death (e.g., JW Cardiology Sep 16 1999). Three recently published studies shed more light on the matter.

One research group analyzed data from 85,000 women who had been free of cardiovascular disease and cancer upon enrollment in the Nurses' Health Study. During 16 years of follow-up, CHD risk was significantly lower among women who ate fish 2-4 times weekly than among those who did <1 time monthly. Even after adjustment for age and other cardiac risk factors, the frequent fish eaters had a 31% lower risk for CHD.

A second research group from the Physicians' Health Study (PHS) previously showed that eating fish reduced sudden-death risk, though not MI risk (JAMA 1998; 279:23). In a follow-up prospective, nested, case-control study, the researchers compared baseline data on blood fatty-acid composition from 94 PHS participants without prior documented CHD who suffered sudden cardiac death (SCD) with parallel data from 184 PHS controls, matched for age and smoking status. Seventeen years of follow-up revealed that progressively higher serum levels of omega-3 fatty acids were associated with progressively -- and dramatically -- lower risk for SCD.

A third group (from Italy) assessed data from >11,000 patients with recent MI who had been allocated to 1 g/day of omega-3 polyunsaturated fatty acids, 300 mg/day of vitamin E, both, or neither. Compared with no treatment, the omega-3 fatty-acid supplement reduced mortality risk by a notable (but nonsignificant) 41% at 3 months -- mostly from reduced risk for sudden death, which, on its own, reached significance by 4 months. Vitamin E added no benefit.

Comment: These 3 studies add to the growing literature supporting the benefit, and elucidating the underlying mechanisms, of omega-3 fatty acids in preventing CHD. Further prospective, randomized trials must firmly establish and explain these benefits. In toto, eating fish regularly (especially dark-meat fish such as salmon) or taking fish-oil supplements appears to reduce CHD risk safely and cheaply for most people.

— JoAnne M. Foody, MD

Published in Journal Watch Cardiology May 31, 2002

Citation(s):

Hu FB et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 2002 Apr 10; 287:1815-21.

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Albert CM et al. Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002 Apr 11; 346:1113-8.

• Medline abstract (Free)

Marchioli R et al. on behalf of the GISSI-Prevenzione Investigators. Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: Time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation 2002 Apr 23; 105:1897-903.

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• Medline abstract (Free)

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