Nutraceutical: Omega 3 fatty acids

Indication: Cardiovascular disease

Source: JAMA, Sep. 12, 2012; 308(10): 1024-33

Research: According to this study, considerable controversy exists regarding the association of omega 3 polyunsaturated fatty acids (PUFAs) and major cardiovascular end points. The objective was to assess the role of omega 3 supplementation on major cardiovascular outcomes. Data were collected from MEDLINE, EMBASE and the Cochrane Central Register of Controlled Trials through August 2012. Randomized clinical trials were used evaluating the effect of omega 3 on all-cause mortality, cardiac death, sudden death, myocardial infarction and stroke. Descriptive and quantitative information was extracted; absolute and relative risk (RR) estimates were synthesized under a random-effects model. Heterogeneity was assessed using the Q statistic and I2. Subgroup analyses were performed for the presence of blinding, the prevention settings and patients with implantable cardioverter-defibrillators; meta-regression analyses were performed for the omega 3 dose. A statistical significance threshold of .0063 was assumed after adjustment for multiple comparisons.
Results: Of the 3,635 citations retrieved, 20 studies of 68,680 patients were included, reporting 7,044 deaths, 3,993 cardiac deaths, 1,150 sudden deaths, 1,837 myocardial infarctions and 1,490 strokes. When all supplement studies were considered, no statistically significant association was observed with all-cause mortality (RR, 0.96; 95% CI, 0.91 to 1.02; risk reduction [RD] -0.004, 95% CI, -0.01 to 0.02), cardiac death (RR, 0.91; 95% CI, 0.85 to 0.98; RD, -0.01; 95% CI, -0.02 to 0.00), sudden death (RR, 0.87; 95% CI, 0.75 to 1.01; RD, -0.003; 95% CI, -0.012 to 0.006), myocardial infarction (RR, 0.89; 95% CI, 0.76 to 1.04; RD, -0.002; 95% CI, -0.007 to 0.002) and stroke (RR, 1.05; 95% CI, 0.93 to 1.18; RD, 0.001; 95% CI, -0.002 to 0.004). Study authors concluded that overall, omega 3 PUFA supplementation was not associated with a lower risk of all-cause mortality, cardiac death, sudden death, myocardial infarction or stroke based on relative and absolute measures of association.