Two large studies published on Saturday show that fish oil-derived medicines can protect people effectively against fatal heart attacks, strokes and other forms of cardiovascular disease.
In the extensive multi-year research effort, various formulations and amounts of drugs made with omega-3 fatty acids have been tested in two groups of people: one suffering from cardiovascular disease or diabetes and one representing the general population , Both studies found that people taking the medication daily were protected from cardiovascular problems compared to placebo patients.
Looking at another dietary supplement, vitamin D, the researchers found no effect on heart disease, but found a correlation with a decline in cancer deaths over time.
The study was published on Saturday at the American Heart Association's 2018 Scientific Sessions in Chicago and published in the New England Journal of Medicine.
In the United States, about 43 million people take statins to lower LDL or "bad" cholesterol. The drugs are said to reduce the risk of heart attacks and strokes. But heart disease is still the main killer of Americans. In recent years, a long-lasting decline in deaths from heart disease has slowed. Researchers are therefore seeking other ways to combat cardiovascular disease beyond known protective factors, such as diet modification, exercise and smoking habits.
One of the REDUCE-IT acronyms presented on Saturday found that individuals with cardiovascular disease who were already on statins were less likely to have serious cardiac problems than being given two grams of the drug Vascepa (ikosapent ethyl) twice were day.
The drug is a purified version of a fish oil component that targets triglycerides, another type of fat in the blood. Elevated triglycerides can harden or thicken arteries, which can lead to strokes and heart attacks. The people taking the drug were compared to those receiving placebo. More than 8,000 people participated in the study.
The drug is sold by Amarin Corp. which sponsored the research. In September, Amarin announced that the study had achieved its primary goals.
Deepak L. Bhatt, Executive Director of Interventional Cardiovascular Programs at the Brigham and Women's Hospital in Boston, who led the study, said the findings could change the practice of cardiology in the same way as the introduction of statins more than 30 years ago.
"Honestly, I've done clinical studies for a long time. And I was not involved in a process that has so much potential to improve the lives of tens of millions of people, "Bhatt said.
In a large study in Japan in 2007, it was noted that the same constituent of the fish oil used in the REDUCE-IT study was promising to protect against cardiovascular problems. But this research did not compare the substance with a placebo and was complicated by the large amount of fish in the typical Japanese diet.
The other fish oil study, VITAL, released on Saturday, looked at the effect of another formulation of omega-3 fatty acids in a drug called Lovaza. The researchers followed nearly 26,000 people for a mean of more than five years. The findings suggested that those on whom the drug was administered were 28 percent less likely to experience a heart attack than patients receiving placebo and 8 percent less likely to have a variety of cardiovascular events. The effect was even more pronounced among African Americans, but the lead researcher said the results needed to be further investigated before they could rely on it.
People who ate less than 1.5 servings of fish per week saw a fall in heart attacks as they increased their intake of omega-3s by taking the drug. The study found no drop in strokes.
JoAnne Manson, Head of Preventive Medicine at Brigham and Women's Hospital, who led the study, said it supports "further support for the benefits of omega-3 for heart health."
Manson called the results "promising signals" about fish oil use, but said that they were not conclusive enough to force people to start taking the drug or fish oil supplements. The study also showed that the drugs are safe enough that people who are already taking fish oil have no reason to discontinue the product, she said in an interview.
Subjects were administered 840 milligrams of the major fatty acids in fish oil daily, less than in a typical salmon portion.
"We would encourage starting more fish in the diet and having at least two servings per week," Manson said. "An advantage to do this through the diet. , , is that fish can replace red meat, saturated fats and processed foods. "
Lovaza is manufactured by GSK but is available in general form. The study was sponsored by the National Institutes of Health.
The VITAL study also looked at vitamin D, which is often recommended for improving bone health in older women and for general health in other people. It turned out that the vitamin had no effect on heart attacks or strokes and did not affect the onset of cancer.
However, vitamin D use might play a role in reducing the number of cancer deaths two or more years later. Manson suggested that vitamin D could help to metastasize cancer or become more invasive. However, she said that this idea needs more research.
She said that people who have already taken small amounts of vitamin D, especially on medical advice have no reason to stop. However, she warned against taking large amounts of the vitamin, eg. For example, 5,000 or 10,000 international units per day, unless a clinician recommends it, as the safety of this practice is unknown.