Two major studies published on Saturday provide evidence that fish-derived fish medications are effective in protecting people from fatal heart attacks, strokes, and other forms of cardiovascular disease.
The great efforts of investigation of several years have proven different formulations and amounts of medications done with omega-3 fatty acids in two groups of people: one that suffered cardiovascular diseases or diabetes and another one that represented the general population. Both studies found that people who took drugs every day enjoyed protection against some cardiac and circulatory problems as compared to those receiving a placebo.
In looking at another supplement commonly consumed, vitamin D, the researchers found no effect on heart disease, but they saw a connection with the reduction of cancer deaths over time.
The research was launched on Saturday at the American Heart Association's 2018 Scientific Sessions in Chicago and published in the New England Journal of Medicine.
About 43 million people in the United States take statins to lower LDL or "bad" cholesterol and drugs are credited with reducing the risk of heart attacks and stroke. But heart disease remains the main killer of Americans. In recent years, a prolonged and constant decrease in deaths due to heart disease has slowed. Thus, researchers seek other ways to combat cardiovascular disease beyond the known protection factors, such as changes in diet, exercise and smoking habits.
One of the studies revealed on Saturday, named by the acronyms REDUCE-IT, determined that people with cardiovascular disease who were already taking statins were less likely to have serious heart problems when they were also given two grams of Vascepa drug (icosapente etil) twice day.
The drug is a purified version of a fish oil component that targets triglycerides, another type of fat in the blood. Elevated triglycerides can harden or thicken the arteries, which can lead to strokes and heart attacks. The people who took the drug were compared to those who received a placebo. The study involved more than 8,000 people.
The drug is made by Amarin Corp., who sponsored the investigation. In September, Amarin announced that the study had reached its primary goals.
Deepak L. Bhatt, executive director of interventionist cardiovascular programs at the Brigham and Women's hospital in Boston, who directed the study, said that the results could change the practice of cardiology in the same way that the introduction of statins more than 30 years
"I honestly have done clinical trials for a long time. And I have not been involved in a test that has so much potential to improve the lives of tens of millions of people," Bhatt said.
In 2007, a large study in Japan determined that the same component of fish oil used in the REDUCE-IT study was promising in protecting against cardiovascular problems. But this investigation did not compare the substance against a placebo, and was complicated by the large amount of fish in the typical Japanese diet.
The other study of fish oil released on Saturday, called VITAL, analyzed the effect of a different formulation of Omega-3 fatty acids in a drug called Lovaza. The researchers followed nearly 26,000 people for a median of more than five years. The results suggest that people who administered the drug were 28 percent less likely to suffer from heart attacks than those who received a placebo and 8 percent less likely to have a variety of cardiovascular events. The effect was even more pronounced among African Americans, but the lead investigator said the results needed more studies before they could be invoked.
People who ate less than 1.5 fish shares weekly observed a drop in the number of heart attacks they suffered when they increased the consumption of Omega-3 by taking the drug. The study did not find a decline in the blows.
JoAnne Manson, head of the preventive medicine division at Brigham and Women's Hospital, who directed the study, said "further supports … the benefits of omega-3 in heart health."
Manson called the "promising signs" results on the consumption of fish oil, but said they are not sufficiently conclusive to force people to start taking the drug or fish oil supplements. The study also showed that the medication is safe enough so that people who already take fish oil have no reason to stop, said in an interview.
People in the study received 840 milligrams of the main fatty acids in fish oil every day, less than in a typical salmon portion.
"We would encourage you to start with more fish in the diet and have at least two servings per week," Manson said. "An advantage of doing it through the diet … is that fish can replace red meat, saturated fat and processed foods."
Lovaza is manufactured by GSK, but it is available in a generic way. The study was sponsored by the National Institutes of Health.
The VITAL study has also studied vitamin D, which is often recommended to improve bone health in older women and general health in other people. He found that the vitamin had no effect on heart attacks or stroke and did not affect the incidence of cancer.
But vitamin D intake may have some role in reducing the number of deaths from cancer two or more years later, the research showed. Manson suggested that vitamin D can help prevent the cancer from being metastasized or become more invasive. But she said the idea needs more research.
She said that people already taking modest amounts of vitamin D, especially with the advice of doctors, have no reason to stop. But she warned against taking large doses of vitamin, such as 5,000 or 10,000 international units per day, unless a clinician recommends it, because the safety of this practice is unknown.