Fresh scientific research has debunked the myth about the absolute benefits of omega-3

For many heart patients, its use may even be dangerous.

We used to give fish oil to all children in kindergartens, but now omega is prescribed to a lot of patients to prevent cardiovascular diseases, lower cholesterol levels and maintain health. Meanwhile, recently updated data from the American Heart Association guidelines on the treatment of patients with chronic coronary heart disease appeared: “The use of fish oil and omega-3 fatty acids in heart patients is not recommended due to the lack of effect in reducing cardiovascular events.” Moreover, a scientific study was recently published that showed that taking omega in older people after a heart attack… worsens their prognosis.

High intakes of marine omega-3 polyunsaturated fatty acids (PUFAs) are associated with a reduced risk of cardiovascular events, but until now this postulate has not been studied in patients with a recent history of acute myocardial infarction (AMI). These people are at particularly high risk of developing new cardiovascular diseases. This means that omega must help them first. Norwegian scientists decided to test this and observed a group of elderly patients aged 70–82 years who had recently suffered a heart attack (2–8 weeks) for two years. They were prescribed high doses of omega-3 daily. It was assumed that as a result they would have a reduced risk of a second heart attack.

In 2021, Norwegian scientists published the results of their research. Unfortunately, there was no significant improvement in the prognosis of the study participants compared to the placebo group that received corn oil. Rates for recurrent heart attacks, strokes, death from all causes, and hospitalization for heart failure were almost identical in both groups. “We were unable to detect a reduction in the incidence of clinical events in elderly patients with recent acute myocardial infarction who received daily omega-3 PUFA supplementation for 2 years,” the scientists concluded. And they noted the pointlessness of prescribing fish oil for the prevention of cardiovascular diseases.

And recently, the same group of authors published an additional publication with the result of a secondary analysis of the anamnesis of the same patients from the point of view of the development of atrial fibrillation (atrial fibrillation, a serious disturbance of heart rhythm). And then a shock awaited them: it turned out that in the group receiving omega, the rate of atrial fibrillation was twice as high.

At baseline, 759 of 1014 (75%) patients had no history of atrial fibrillation. But during observation it developed in 43 patients. In addition, 27 patients experienced episodes of so-called microfibrillation, that is, there were 70 patients in total. Moreover, 46 of these 70 were from the group of patients taking omega-3 (there were almost half as many of these in the placebo group, 24).

The scientists’ conclusion this time is clear: taking supplements with omega-3 PUFAs after a myocardial infarction increases the risk of developing atrial fibrillation. But it was previously assumed that omega-3 polyunsaturated fatty acids have antiarrhythmic properties… Alas, the mechanisms underlying the increased risk of atrial fibrillation when taking omega-3 PUFAs remain unclear.

“Omega-3 polyunsaturated fatty acids have been studied in patients with cardiovascular diseases for several decades, but the results regarding the effect on cardiovascular events are contradictory,” says cardiologist Andrei Nikityuk. “Early studies showed significant reductions in cardiovascular events and mortality with both increased consumption of fatty fish and omega-3 PUFAs, while more recent studies found no such effect. So their benefits have not been proven. Our doctors prescribe them quite often, but I would approach such recommendations with great caution. It’s one thing if they don’t help, but they can also do harm. Several studies have already shown an increased risk of developing atrial fibrillation in patients taking omega-3, and the higher the dose, the higher this risk. So fish oil should be taken with great caution, especially in patients with cardiovascular diseases, if only because it certainly does not reduce the frequency of atherosclerotic events.”

Cardiologist Alexei Erlikh, MD, reminds us that the new American Heart Association guidelines for the treatment of patients with chronic coronary artery disease encourage non-pharmacological treatments, including a healthy diet and exercise. Statins also remain in the recommendations as the first line of therapy for lowering cholesterol levels. “The use of dietary supplements, including fish oil, omega-3 fatty acids or vitamins, is not recommended for patients with chronic ischemic heart disease, given the lack of effect in reducing cardiovascular events,” notes Alexey Erlikh.

Published in the newspaper “Moskovsky Komsomolets” No. 29112 dated September 12, 2023

Newspaper headline:
Heart patients have no time for fish oil