Are fish oil supplements for CV protection dead in the water?

  • Abbasi J
  • JAMA
  • 18 Apr 2018

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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  • Conflicting findings have left an aftertaste of doubt about the usefulness of fish oil supplements  against cardiovascular disease (CVD).
  • A 2018 meta-analysis of 10 clinical trials found little benefit, contrasting somewhat with an American Heart Association (AHA) science advisory that supplements could be considered for patients with recent myocardial infarction.
  • 4 in-progress trials may help decide whether fish oil supplements can sink or swim.
  • In the meantime, the risk of using the supplements appears to be minimal. 

Why this matters

  • Fish oil supplements had shown promise in reducing CVD-related endpoints, but mounting evidence casts doubt on that potential.

Key results

  • The 2018 meta-analysis included 10 trials with 77,917 participants; the authors concluded that supplements offer no benefit. 
  • The AHA advisory concluded that without high CVD risk, the supplements offer no benefit, but called supplementation “reasonable” as secondary prevention postmyocardial infarction.
  • 4 upcoming trials to watch:
    • ASCEND (A Study of Cardiovascular Events iN Diabetes, Phase 4): 100 mg aspirin vs placebo or omega-3 fatty acids (omega-3s) in patients with diabetes; endpoint, serious vascular event prevention; estimated completion date was September 2017.
    • VITAL (VITamin D and OmegA-3 TriaL, Phase 3): randomized trial with 25,871 participants taking daily vitamin D or omega-3s; endpoints are cancer, heart disease, stroke risk; estimated completion date, June 2018.
    • REDUCE-IT (Phase 3): this population has hypertriglyceridemia, and the test drug is a purified omega-3; endpoint, long-term cardiovascular event reduction; estimated complete date, July 2018.
    • STRENGTH (Phase 3): omega-3s in patients with high CVD risk and hypertriglyceridemia; endpoint, major adverse cardiac events; estimated completion date, October 2019.