Positive Health Online

Abstract

DURRINGTON and colleagues, University Department of Medicine, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, UK, pdurrington@hq.cmht.nwest.nhs.uk, investigated the safety and efficacy of a concentrate of fish oil-derived omega-3 polyunsaturated fatty acids (PUFAs) in lowering blood triglyceride levels in patients with coronary heart disease (CHD) and persisting hypertriglyceridaemia.

Background

Omega-3 fatty acids have been reported to prolong life in patients who have suffered myocardial infarction (MI). To date, doses of such fatty acids that have been used in clinical trials investigating their effects on coronary endpoints have only had minimal triglyceride-lowering effects.

Methodology

In this double-blind clinical trial, 59 patients with CHD receiving simvastatin (10-40 mg daily), with serum triglycerides >2.3 mmol/L, were randomized to receive 2 g daily Omacor (an 84% concentrate of omega-3, long-chain PUFAs from fish oil) or placebo for 24 weeks. At the end of the double-blind trial, 46 patients continued on open active treatment for a further 24 weeks.

Results

Patients on Omacor showed a sustained significant 20-30% decrease in serum triglycerides (p<0.005) and a 30-40% decrease in very low-density lipoprotein (VLDL) cholesterol (p<0.005) at 3, 6 and 12 months compared with baseline or placebo. Omacor had no deleterious effects on low-density (LDL) or high-density lipoprotein (HDL) cholesterol or in biochemical and haematological safety tests. Omacor did not have any adverse effect on glycaemic control in patients with diabetes. Patients with diabetes taking Omacor showed a decrease in serum triglyceride levels that was at least as great as that seen in non-diabetic patients. One patient on placebo died of an acute MI. Three patients (two on placebo and one on Omacor) withdrew from the trial. Omacor was generally well tolerated.

Conclusion

References

Durrington PN et al. An omega-3 polyunsaturated fatty acid concentrate administered for one year decreased triglycerides in simvastatin treated patients with coronary heart disease and persisting hypertriglyceridaemia. Heart 85 (5): 544-8. May 2001.

Comment

Following several decades of research and many types of dietary interventions, it has become almost commonplace knowledge that dietary and lifestyle approaches can significantly improve outcome for heart disease patients. The research continues to flesh out the evidence; it is hoped that these results become incorporated into clinical practice, which would obviate the need for patients to take drugs with severe side effects and risks. @i:89