British Journal of Nutrition

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Long chain omega-3 fatty acids and cardiovascular disease: a systematic review

Javier Delgado-Listaa1a2, Pablo Perez-Martineza1a2, Jose Lopez-Mirandaa1a2 and Francisco Perez-Jimeneza1a2 c1

a1 Lipids and Atherosclerosis Unit, Department of Medicine, IMIBIC/Hospital Universitario Reina Sofía/Universidad de Cordoba, Cordoba, Spain

a2 CIBER Fisiopatologia Obesidad y Nutricion (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain

Abstract

Introduction: Cardiovascular disease remains the commonest health problem in developed countries, and residual risk after implementing all current therapies is still high. The use of marine omega-3 fatty acids (DHA and EPA) has been recommended to reduce cardiovascular risk by multiple mechanisms. Objectives: To update the current evidence on the influence of omega-3 on the rate of cardiovascular events. Review Methods: We used the MEDLINE and EMBASE databases to identify clinical trials and randomized controlled trials of omega-3 fatty acids (with quantified quantities) either in capsules or in dietary intake, compared to placebo or usual diet, equal to or longer than 6 months, and written in English. The primary outcome was a cardiovascular event of any kind and secondary outcomes were all-cause mortality, cardiac death and coronary events. We used RevMan 5·1 (Mantel-Haenszel method). Heterogeneity was assessed by the I2 and Chi2 tests. We included 21 of the 452 pre-selected studies. Results: We found an overall decrease of risk of suffering a cardiovascular event of any kind of 10 % (OR 0·90; [0·85–0·96], p = 0·001), a 9 % decrease of risk of cardiac death (OR 0·91; [0·83–0·99]; p = 0·03), a decrease of coronary events (fatal and non-fatal) of 18 % (OR 0·82; [0·75–0·90]; p < 1 × 10− 4), and a trend to lower total mortality (5 % reduction of risk; OR 0·95; [0·89–1·02]; p = 0·15. Most of the studies analyzed included persons with high cardiovascular risk. Conclusions: marine omega-3 fatty acids are effective in preventing cardiovascular events, cardiac death and coronary events, especially in persons with high cardiovascular risk.

Correspondence:

c1 Corresponding author: F. Perez-Jimenez, fax +34 957 204763, email fperezjimenez@uco.es

Footnotes

† Javier Delgado-Lista and Pablo Perez-Martinez contributed equally to the production of this article.

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