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Why people at risk for heart disease might want to avoid fish oil

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A new study looks at the risk of taking omega-3 supplements for people at high risk for heart disease. Getty Images
  • New research shows that taking omega-3 supplements is associated with an increased risk of atrial fibrillation in people at high risk for or pre-existing heart disease.
  • Experts say the relationship between omega-3 supplement use and heart health is complicated.
  • Talk to your doctor about your risks and what is best for you.

While earlier research Found strong evidence that omega-3 fatty acids benefit heart health, this popular supplement can also pose a significant risk to some people.

According to a new analysis from the European Society of Cardiology, omega-3 fatty acid supplements are associated with an increased likelihood of developing atrial fibrillation (AFib) in people with high triglyceride levels.

Triglycerides are a type of fat found in the blood.

“Currently, fish oil supplements are indicated for patients with elevated plasma triglycerides to reduce cardiovascular risk,” said study author Salvatore Carbone, PhD, of Virginia Commonwealth University.

“Due to the high incidence of elevated triglycerides in the population, they can be commonly prescribed,” he added.

The new analysis looked at five randomized controlled trials and examined the effects of omega-3 fatty acid supplements on cardiovascular outcomes.

Study participants had high triglyceride levels. They had an increased risk of cardiovascular disease or had already been diagnosed with it.

More than 50,000 participants received fish oils (a source of omega-3) or placebo. Researchers followed them up for up to 7.4 years. The dosage of fish oil was between 0.84 grams and 4 grams daily.

Researchers found that omega-3 fatty acid supplements were associated with significantly increased risks of AFib compared with placebo.

“Atrial fibrillation is an arrhythmia, an abnormal heart rhythm, characterized by irregular electrical activity in the upper chamber of the heart, the left atrium,” says Dr. Michael Goyfman, Director of Clinical Cardiology at Long Island Jewish Forest Hills in New York, Healthline.

“While some people might feel [heart] palpitations associated with atrial fibrillation, others have no symptoms, ”he said.

Goyfman added that the biggest concern with AFib is the risk of stroke or something else thromboembolic event, where a blood clot can form in the heart and then break off and travel to the brain or other organs.

“To reduce this risk, blood thinners are often prescribed to patients with AFib at higher risk of stroke,” Goyfman said.

Omega-3s are essential fats that the body needs to stay healthy.

According to the National Institutes of Health, omega-3s are not produced in the body. We need to consume them to maintain healthy levels.

Omega-3s come in three types:

  • alpha-linolenic acid (ALA)
  • eicosapentaenoic acid (EPA)
  • docosahexaenoic acid (DHA)

The National Institutes of Health emphasizes that omega-3s are an important part of the membranes that surround every cell in our bodies.

The levels of DHA are especially high in the eyes, brain and sperm and play an important role in many bodily functions.

Goyfman confirmed that for healthy people who eat omega-3 as part of a Mediterranean diet, the incidence of cardiovascular events had dropped markedly.

A science advice from 2019, published in the journal Circulation, said that 4 grams per. Today, prescription omega-3s can lower triglyceride levels by 20 to 30 percent in most people.

But how important is it to reduce these levels?

“Triglycerides are a type of fat in our bodies and their levels are measured with a blood test similar to other fats, such as HDL, the ‘good’ cholesterol and LDL, the ‘bad’ cholesterol,” said Goyfman.

“Although there has been some association between high triglyceride levels and cardiovascular disease, a causal relationship has never been established,” he said, “and we do not currently use triglyceride levels to calculate anyone’s risk of stroke or heart attack.”

Asked if the benefits of omega-3 supplements for healthy people outweigh their potential risks, says Dr. Laurence M. Epstein, system director of electrophysiology at Northwell Health’s Sandra Atlas Bass Heart Hospital in New York, said it was “unclear.”

“This remains controversial, and that is why this study was conducted,” Epstein said. “Some have claimed that they can lower the risk of coronary artery disease by affecting lipids such as triglycerides. Others have suggested that they may reduce the risk of life-threatening heart rhythm problems. ”

Epstein stressed the importance of telling your doctor what supplements you are taking.

“It is crucial that patients tell their doctors all the supplements they take, ”he said. “This study suggests that if you have atrial fibrillation, you may need to avoid these supplements.”

“The REDUCE-IT study showed that patients with high triglycerides who took specific prescription omega-3 supplements had a reduced risk of cardiovascular events including cardiovascular death,” Goyfman said. “As such, this is a complex issue to address.”

According to Goyfman, AFib can be treated with appropriate medications, procedures, or both. The risk of stroke can be reduced by taking blood thinners.

“Some may argue that a reduction in death outweighs the risk of developing atrial fibrillation,” Goyfman said.

“On the other hand,” he warned, “people who are not in a category where they can benefit from omega-3 supplements may be taking unnecessary risks of developing atrial fibrillation.”

Goyfman said it is important to keep in mind that there are different types of omega-3s.

Only EPA was used in the REDUCE-IT trial, and a mixture of EPA and DHA was used in STRENGTH test, which showed no benefit, ”he said.

“If we use different compounds, should we probably compare apples to oranges?” Said Goyfman.

Until further studies are conducted on specific types and doses of omega-3s, Goyfman will “not recommend patients make a decision to either stop or start omega-3 supplements without talking to their doctor.”

Epstein added that many supplements are poorly regulated, often have no warnings and should generally be better regulated.

New research shows that taking omega-3 supplements is associated with an increased risk of atrial fibrillation in people at high risk for or pre-existing heart disease.

Experts say that while omega-3s are important for health, the relationship between using these supplements and heart health is complicated.

They also say that supplements are generally poorly regulated. It is best to talk to your doctor before including omega-3 supplements in your diet.

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