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The American
Heart Association (AHA) has endorsed the use of omega-3 fatty acids
for secondary prevention of cardiovascular events in people with
documented coronary artery disease (CAD). The recommendation calls
for approximately 1g/day of a mixture of docosahexaenoic acid (DHA)
and eicosapentaenoic acid (EPA). Although the AHA statement identifies
oily fish as the ideal source, fish oil in capsules or liquid form
is also an acceptable option.
To date,
the strongest evidence showing a CV benefit from omega-3-fatty acid
intake derives from 3 large controlled trials in which a total of
32,000 participants were randomized to a control group or to receive
omega-3 fatty acid supplements containing DHA and EPA. In these
trials, the supplemented group had a 19% to 45% reduction in CV
events versus the control group.
Patients
with hypertriglyceridemia should consume 3 to 4g/day of DHA and
EPA, which can lower triglyceride levels by 20% to 50%.
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In patients
with severely elevated triglyceride levels (more than 500 mg/dl),
3 to 4 g/day of DHA and EPA typically lowers triglyceride levels by
45%. When added to baseline statin therapy in patients with triglyceride
levels of 200 to 499 mg/dl, this dosage lowers triglyceride levels
by an additional 23% to 29%.
Two meals
of oily fish per week can provide 400 to 500mg/day of DHA and EPA,
but patients with hypertriglyceridemia must use fish oil supplements
to reach target levels of 1 g/day of DHA and 3 to 4 g/day of EPA.
"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 reviewers write.
"
Omega-3
fatty acid supplements can be taken at any time, in full or divided
doses, without raising concerns for interactions with any medications",
the reviewers conclude. To get more details, please go to: www.medscape.com/viewarticle/
571594?sssdmh=dml.438947&src=nldne
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