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


Share on PinterestA new study examines 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 linked to an increased risk of atrial fibrillation in people who are at high risk or have an 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 previous research found strong evidence that omega-3s are beneficial for heart health, this popular supplement can also pose significant risk for some people.

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

Triglycerides are a type of fat in the blood.

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

“Because of the high prevalence of elevated triglycerides in the population, they can be prescribed frequently,” he added.

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

The study participants had high levels of triglycerides. You were at increased risk of developing cardiovascular disease or had already been diagnosed.

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

The researchers found that omega-3 fatty acid supplementation was linked to a significantly increased risk of AFib compared to a placebo.

“Atrial fibrillation is an arrhythmia, an abnormal heart rhythm that is characterized by irregular electrical activity in the upper chamber of the heart, the left atrium,” said Dr. Michael Goyfman, director of clinical cardiology at Long Island Jewish Forest Hills in New York, told Healthline.

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

Goyfman added that the main problem with AFib is the risk of a stroke or other thromboembolic event, in which a blood clot can form in the heart and then break off and get to the brain or other organs.

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

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

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

Omega-3 fatty acids come in three types:

  • Alpha Linolenic Acid (ALA)
  • Eicosapentaenoic acid (EPA)
  • Docosahexaenoic acid (DHA)

The National Institutes of Health emphasize that omega-3 fatty acids are an important part of the membranes that surround every cell in our body.

The DHA levels in the eyes, brain and sperm are particularly high and play an important role in many body functions.

Goyfman confirmed that “the frequency of cardiovascular events was significantly reduced” in healthy people who consume omega-3 fatty acids as part of a diet such as the Mediterranean Diet.

A 2019 scientific recommendation published in the journal Circulation said that 4 grams of prescription omega-3 fatty acids per day can lower triglyceride levels by 20 to 30 percent in most people.

But how important is it to reduce these values?

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

“While there is some link between high triglyceride levels and cardiovascular disease, causality has never been established,” he said, “and we don’t currently use triglyceride levels to calculate a person’s risk of stroke or heart attack.”

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

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

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

“It is critical that patients tell their doctors about any supplements they are taking,” he said. “This study suggests that if you have atrial fibrillation you might want to avoid these supplements.”

“The REDUCE-IT study showed that high triglyceride patients who took certain prescription omega-3 supplements were at lower risk of cardiovascular events, including cardiovascular death,” Goyfman said. “As such, this is a complex question to be answered.”

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

“Some might argue that reducing deaths outweighs the risk of atrial fibrillation,” Goyfman said.

“On the other hand,” he warned, “people who do not fall into a category where they might benefit from omega-3 supplementation may be at unnecessary risk of developing atrial fibrillation.”

Goyfman said it was important to keep in mind that there are different types of omega-3 fatty acids.

“The REDUCE-IT study only used EPA and the STRENGTH study used a mixture of EPA and DHA that showed no benefit,” he said.

“If different compounds have been used, do we compare apples to oranges?” Said Goyfman.

Until further studies are done on specific types and dosages of omega-3 fatty acids, Goyfman would not recommend patients make the decision to either stop or start omega-3 supplementation without speaking to their doctor.

Epstein added that many dietary supplements are poorly regulated, often without warnings, and generally should be better regulated.

New research shows that taking omega-3 supplements is linked to an increased risk of atrial fibrillation in people who are at high risk or have an existing heart disease.

Experts say while omega-3 fatty acids are essential to health, the relationship between using these supplements and heart health is complicated.

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


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