Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association
Siscovick et al. • Circulation
Key Finding
Secondary CHD prevention: ~10% cardiac death reduction (RR 0.91, 95% CI 0.85-0.98); Heart failure: 9% mortality reduction (RR 0.91, 95% CI 0.83-0.99)
Key Findings
- 1Secondary CHD: 10% cardiac death reduction (RR 0.91)
- 2Heart failure: 9% mortality reduction
- 3Not indicated for primary prevention
- 4Not indicated for diabetes, stroke, or AF
Original title: “Omega-3 Polyunsaturated Fatty Acid (Fish Oil) Supplementation and the Prevention of Clinical Cardiovascular Disease: A Science Advisory From the American Heart Association”
Plain English Summary
AHA science advisory reviewing RCTs of EPA+DHA supplementation for CVD prevention. Treatment is reasonable for secondary prevention of CHD (Class IIa) with ~10% reduction in cardiac death, but not indicated for primary prevention, diabetes, stroke prevention, or atrial fibrillation.
In-Depth Analysis
Abstract
The advisory reviewed randomized controlled trials (RCTs) of EPA+DHA supplementation for cardiovascular disease prevention across multiple populations.
Key Recommendations
Secondary Prevention of CHD (Class IIa - "Treatment is reasonable")
- •Meta-analysis showed ~10% reduction in cardiac death (RR 0.91, 95% CI 0.85-0.98)
- •Typical dose: ~1000 mg/day EPA+DHA
- •Benefit primarily from reduced sudden cardiac death
Heart Failure with Reduced Ejection Fraction (Class IIa)
- •GISSI-HF trial (n=6,875): Total mortality reduction of 9% (RR 0.91, 95% CI 0.83-0.99)
- •CV hospitalization/death reduction: 8% (RR 0.92, 95% CI 0.85-0.99)
- •Dose: 840 mg/day EPA+DHA
NOT Recommended (Class III)
- •Diabetes/prediabetes: "Treatment is not indicated"
- •Stroke prevention: "Treatment is not indicated"
- •Atrial fibrillation recurrence: "Treatment is not indicated"
Conclusions
"Even a potential modest reduction in CHD mortality (10%) would justify treatment" with "a relatively safe therapy."
Paradigm Relevance
How this study applies to different clinical perspectives:
Standard Medical
RelevantConventional clinical guidelines used by most doctors
Why it matters:
Establishes evidence-based indications for omega-3 supplementation in clinical practice.
Research Consensus
RelevantCurrent scientific understanding, often ahead of guidelines
Why it matters:
Clarifies where evidence supports supplementation vs where it does not.
Metabolic Optimization
RelevantProactive targets for optimal health, not just disease absence
Why it matters:
Highlights that supplementation benefits depend on baseline omega-3 status.
Study Details
- Type
- Clinical Guideline
- Methodology
- AHA Science Advisory reviewing randomized controlled trials of EPA+DHA supplementation across multiple cardiac conditions and populations
Evidence Quality
Grade A - AHA Science Advisory based on RCT evidence. Source: PMC6903779
Related Biomarkers
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Original Source
DOI (Digital Object Identifier) is a permanent link to this publication. Unlike website URLs that can change, a DOI always resolves to the correct source.
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