MONDAY, Could 3, 2021 (HealthDay Information) — Many individuals take fish oil to guard their heart, however a brand new examine means that prescription variations might elevate the danger of a typical coronary heart rhythm dysfunction.
At subject are prescription-strength omega-3 fatty acids, that are naturally present in fish oil. The medicines are sometimes prescribed to individuals with very excessive triglycerides, a sort of blood fats linked to elevated danger of heart attack and stroke.
In response to the American Coronary heart Affiliation, prescription omega-3s can decrease triglycerides by 20% to 30% in most individuals.
However the medicines are additionally controversial, as a result of their final advantages for the center are unclear.
Now the brand new examine — an evaluation of 5 previous clinical trials — suggests warning is so as. General, trial sufferers given omega-3s have been over one-third extra prone to develop atrial fibrillation (a-fib) than these given a placebo. The fish oil doses taken ranged from 0.84 grams to 4 grams per day.
A-fib is a typical coronary heart rhythm dysfunction, or arrhythmia, wherein the center’s higher chambers start to quiver chaotically as a substitute of contracting successfully.
A-fib shouldn’t be instantly life-threatening, nevertheless it’s “not benign,” both, mentioned Dave Dixon, one of many researchers on the examine and an affiliate professor at Virginia Commonwealth College (VCU), in Richmond.
Over time, Dixon mentioned, a-fib can result in problems like heart failure or stroke.
Precisely how prescription-strength omega-3 might contribute to a-fib is unclear, in response to Dixon.
Nonetheless, the elevated danger was pretty constant throughout the trials — extra constant, in actual fact, than coronary heart advantages have been, mentioned co-researcher Salvatore Carbone, an assistant professor at VCU.
In all 5 trials, there have been extra a-fib circumstances amongst omega-3 sufferers than placebo sufferers, although the distinction in danger was not statistically important in all research.
However when the researchers pooled the outcomes of all 5 trials, there was a transparent outcome: Omega-3 sufferers have been 37% extra prone to develop a-fib than placebo sufferers have been.
In distinction, just one trial confirmed that an omega-3 product might minimize the dangers of different coronary heart circumstances.
In that trial, dubbed REDUCE-IT, sufferers utilizing a product known as Vascepa (icosapent ethyl) noticed their danger of “cardiovascular occasions” drop by 25%. That included coronary heart assault, stroke and loss of life from cardiovascular causes.
Even in that examine, although, a-fib danger rose amongst omega-3 customers, by 35%.
Why has just one trial discovered coronary heart advantages? Once more, it isn’t but clear, Dixon mentioned.
However, he added, Vascepa is completely different from the fish oil merchandise examined within the different trials. It incorporates just one omega-3, known as EPA, whereas the opposite merchandise include a mix of EPA and DHA.
And within the REDUCE-IT trial, Dixon mentioned, increased ranges of EPA in sufferers’ blood correlated to decrease cardiovascular dangers.
That hints, he mentioned, that specializing in EPA is likely to be “the best way to go sooner or later.” However the conflicting findings on the advantages of omega-3s — together with the potential danger of a-fib — spotlight the necessity for extra research, the researchers mentioned.
The evaluation was printed April 29 within the European Coronary heart Journal — Cardiovascular Pharmacotherapy.
Findings on the center advantages of fish oil have certainly been “inconsistent,” mentioned Linda Van Horn, a member of the center affiliation’s vitamin committee and a professor at Northwestern College Feinberg College of Drugs, in Chicago.
And that features low-dose, over-the-counter fish oil dietary supplements.
“There are restricted and inconsistent knowledge relating to the profit or danger of taking fish oil dietary supplements,” Van Horn mentioned.
So the center affiliation recommends consuming two servings of fish per week as a substitute. Van Horn mentioned that fatty fish, corresponding to salmon, trout, albacore tuna and herring, are the perfect sources of omega-3s.
The trials within the present evaluation examined prescription-strength omega-3s. However Carbone mentioned he could be cautious about over-the-counter fish oil dietary supplements, too.
“We do not know if over-the-counter merchandise might have these identical results,” he mentioned.
Over-the-counter fish oil is taken into account a dietary complement, so it isn’t regulated by the U.S. Meals and Drug Administration as a drug could be, Dixon identified.
Each he and Carbone mentioned it is best to speak to a physician or pharmacist earlier than beginning any fish oil product — and that individuals on prescription omega-3s ought to converse with their physician earlier than stopping.
Harvard Medical College has extra on fish oil and heart health.
SOURCES: Salvatore Carbone, PhD, assistant professor, kinesiology and well being sciences, Virginia Commonwealth College, Richmond, Va.; Dave L. Dixon, PharmD, affiliate professor, ambulatory care, and vice-chair, scientific providers, division of pharmacotherapy and outcomes science, Virginia Commonwealth College, Richmond, Va.; Linda Van Horn, PhD, RD, professor and chief, vitamin division, division of preventive drugs, Northwestern College Feinberg College of Drugs, Chicago, and member, Vitamin Committee, American Coronary heart Affiliation, Dallas; European Coronary heart Journal—Cardiovascular Pharmacotherapy, April 29, 2021, on-line