Daily Omega-3 Supplement, But Not Statin, Benefits Chronic Heart Failure Patients

Omega-3 fatty acid supplements, but not statin drugs, can help patients with chronic heart failure, show two parallel studies conducted for the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico Heart Failure (GISSI-HF) trial and released for early online publication in the Lancet August 31, 2008.

Omega-3s' positive outcomes are especially important since few effective options exist for patients with chronic heart failure.

In one study, Italian researchers gave 3,494 heart failure patients 1 gram/day of omega-3 fatty acids, while roughly the same number, (3,481), got a placebo. In the parallel study, the same team of Italian doctors gave 2,285 patients 10 mg daily of rosuvastatin (Crestor, AstraZeneca) and 2,289 patients a placebo.

After 3.9 years, omega-3 fatty acids had reduced all-cause mortality 9% and hospital admission for cardiovascular reasons (cardiovascular-induced death, nonfatal heart attack, or stroke) by 8%, while the statin drug produced no similar benefits.

Despite the fact that treatment with rosuvastatin lowered LDL cholesterol 27% at 3 years—down from 123 mg/dL at the beginning of the study to 90 mg/dL—the statin did not provide heart failure patients with the cardio-protective benefits delivered by omega-3 fatty acids.

Why might omega-3 fats help? Cell membranes, where key metabolic enzymes are embedded, are largely composed of fats. The higher the DHA content, the more flexible the cell membrane, and the more effectively enzymes can maneuver. EPA, which also concentrates in cell membranes, is the precursor of anti-inflammatory eicosanoids.  Plus omega-3s have been shown to increase levels of HDL cholesterol and to stabilize heart cells' electrical system, promoting a lower QTc interval and lessening the chance of arrhythmias. In contrast, statin drugs lower potentially harmful LDL cholesterol, which may not have much impact on heart failure.

While researchers were disappointed with statins' failure to help heart failure patients, their response to omega-3s' cardio-protective potential has been uniformly enthusiastic.

"This study changes the certainty of the evidence we have about fish oils," said president of the American College of Cardiology, Dr. Douglas Weaver, who also noted that U.S. guidelines would likely change to recommend that heart patients eat more fish or take omega-3 fatty acid supplements. "This is a low-tech solution and could help all patients with cardiovascular problems," said Weaver.

Chair of the GISSI-HF steering committee, Dr Luigi Tavazzi, presented the omega-3 data to the media during a European Society of Cardiology press conference, calling treatment with omega-3s an "effective, safe, simple, and cheap" option for patients with chronic heart failure. And in an editorial accompanying the two studies in the Lancet, Dr Gregg Fonarow at U.C.L.A seconded Tavassi, writing "…supplementation with n-3 polyunsaturated fatty acids should join the short list of evidence-based life-prolonging therapies for heart failure."

Additional compelling evidence for omega-3s cardiovascular benefits comes from a June 2008 Mayo Clinic Proceedings review of 3 large controlled trials of 32,000 participants randomized to receive omega-3 supplements containing docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) or placebo. These trials showed reductions in cardiovascular events of 19% to 45% in those given omega-3s.

Review authors noted that while target DHA and EPA consumption levels are about 1 gram/day for those with known coronary artery disease, and at least 500 mg/day for those without cardiovascular disease, patients with high triglycerides benefit from treatment with 3 to 4 grams/day of DHA and EPA, a dosage that lowers triglyceride levels by 20% to 50%.

They also emphasized that combination therapy with omega-3 fatty acids and a statin is a safe and effective way to improve lipid levels and cardiovascular prognosis beyond the benefits provided by statin therapy alone.

The July 2008 issue of the Journal of the American Dietetic Association notes one caveat: High intakes of omega-3s can cause excessive bleeding in some individuals. Patients taking more than 3 grams/day of EPA and DHA (the long chain omega-3 fatty acids) should do so only under a physician's care. The US Food and Drug Administration has set the “generally regarded as safe” level for long-chain omega-3s at 3.0 g/day.

ReferencesClick to Show/Hide References

  1. GISSI-HF investigators. Effect of n-3 polyunsaturated fatty acids in patients with chronic heart failure (the GISSI-HF trial): a randomized, double-blind, placebo-controlled trial. Lancet 2008. DOI: 10.1016/S0140-6736(08)61241-6.

  2. GISSI-HF investigators. Effect of rosuvastatin in patients with chronic heart failure (the GISSI-HF trial): a randomized, double-blind, placebo-controlled trial. Lancet 2008. DOI: 10.1016/S0140-6736(08)61241-6.

  3. Fonarow GC. Statins and n-3 fatty acid supplementation in heart failure. Lancet 2008. DOI: 10.1016/S0140-6736(08)61239-8.

  4. Lee JH, O'Keefe JH, Lavie CJ, et al. Omega-3 fatty acids for cardioprotection. Mayo Clin Proc. 2008 Mar;83(3):324-32.

  5. Kris-Etherton PM, Hill AM. N-3 fatty acids: food or supplements?. J Am Diet Assoc. 2008 Jul;108(7):1125-30.

 

8 Comments

1. March 18, 2010
6:50am

By Fulvic Acid

This is what it really takes. I think take at regular basis and in enough measures I am sure it will really be helpful to gain good health and results in something really beneficiary for the heart.

2. May 17, 2010
3:58am

By anthony morrison

It is known that omega-3 fatty acids and I submit that the effects of stain use on this patient population was to produce an additional energy deficit in hearts already burdened with failure.

3. August 18, 2010
4:26am

By Actinic

Dietary supplement are not the same as diet pills. I think when you are talking about ” diet pills ” you mean fat burning pills that speed up your metabolism, like Hydroxicut or Alli. The vitamins that you bought will supplement your diet and make sure you are getting all of the nutrients that you need, helping your immune system and giving you more daily energy, but they won’t help you lose weight.

4. December 2, 2010
9:03am

By Laser Treatments irvine

This is something I have done much research on it. I am very careful about what I have done my body, which is why I spent a lot of time researching brands of fish oil to see if some people were actually better than others. And I can definitely say that the brand of high quality omega 3 fish oil supplements.

5. December 7, 2010
9:55am

By excessive sweating

I would like to thank you for the wonderful and interesting information you have been sending. I take Onega 3 fish oil for reduce the heart attack.

6. January 10, 2011
2:06am

By liposculpture guide

Statin treatment with Crestor does not affect clinical outcomes in patients with chronic heart failure.

7. January 12, 2011
2:42am

By Finroo

These were really wonderful information given by you, well I think that if your doctor, recommends you take statin drugs for chronic heart failure you may want to give it a second thought.

8. June 8, 2011
8:10am

By sterilization pouches

Omega3 gives positive outcomes to us. you post the deep thoughts about the omega3 benefits. Thanks for all this stuff.

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Lara Pizzorno is a member of the American Medical Writers Association with 25+ years of experience writing for physicians and the public, Lara is Editor for Longevity Medicine Review as well as Senior Medical Editor for SaluGenecists, Inc. Read more...

Lara Pizzorno, MDiv, MA, LMT

Lara Pizzorno, MDiv, MA, LMT

John Morgenthaler has been active in the field of nutritional medicine since 1986. Today, John travels the world looking for breakthrough nutraceuticals and anti-aging therapies.  He also continues to publish cutting-edge nutrition and medical science books and periodicals. Read more...

John Morgenthaler, Publisher

John Morgenthaler, Publisher