Low-dose supplementation with omega 3 EPA/DHA or ALA did not significantly reduce the rate of major cardiovascular events among older patients who previously had a heart attack, according to research published recently in the New England Journal of Medicine.

For this double-blind, placebo-controlled, multicenter trial, Dutch researchers randomly assigned 4837 patients, 60-80 years of age (78% men), who had had a myocardial infarction and were receiving antihypertensive, antithrombotic and lipid-modifying therapy to receive for 40 months one of four trial margarines: a margarine supplemented with a combination of EPA and DHA (with a targeted additional daily intake of 400 mg of EPA/DHA), a margarine supplemented with ALA (with a targeted additional daily intake of 2 grams of ALA), a margarine supplemented with EPA/DHA and ALA or a placebo margarine.

The patients consumed, on average, nearly 19 grams of margarine per day, which resulted in additional intakes of 226 mg of EPA combined with 150 mg of DHA, 1.9 grams of ALA, or both, in the active-treatment groups. During the follow-up period, a major cardiovascular event occurred in 671 patients (14%). Neither EPA/DHA nor ALA reduced this primary endpoint. In the pre-specified subgroup of women, ALA, as compared with placebo and EPA/DHA alone, was associated with a reduction in the rate of major cardiovascular events that approached significance. The rate of adverse events did not differ significantly among the study groups.

Adam Ismail, executive director of the Global Organization for EPA and DHA Omega-3 (GOED), Salt Lake City, UT, said this low-dose study should not negate the positive findings of previous studies examining EPA/DHA’s effect on secondary prevention in heart health at higher doses.

“GOED supports research that examines all health effects of consuming EPA and DHA rich sources, as our members’ focus is on educating consumers on the complexities of EPA/DHA consumption. While 400 mg of combined EPA/DHA provides a sufficient dose for most healthy individuals, previous clinical studies in individuals having suffered a heart attack suggest that 1000 mg + of EPA/DHA decreases the incidence of secondary cardiovascular events—more than twice the dose administered in the recently published study.”

Mr. Ismail also noted that patients in this study were already receiving state-of-the-art combination drug therapies. In addition, the average heart attack of the patients at the time of enrollment was already more than four years prior and the age of the patients was significantly older than previous studies.