'Should I consume fish oil supplements?'
Medical Director, MWH Heart Stroke and Cancer Centre, MBBS, MRCP , M Med , FAMS , FRCP A VERY common question asked of me by patients is,"Should I consume fish oil supplements?" The fish oil supplements referred to are those containing the omega-3 polyunsaturated fatty acids , namely eicosapentaenoic acid and docosahexaenoic acid .
There are five large RCTs and other smaller RCTs which have been performed to evaluate the effects of omega-3 PUFA supplementation on clinical cardiovascular events in patients with pre-existing heart artery disease. Taken together, the cumulative findings from RCTs suggest that omega-3 PUFA supplements may reduce incidents of heart artery disease death, possibly through a reduction in sudden death during a heart attack. However, fish oil supplementation does not prevent future heart attacks.
While earlier studies have shown a large reduction in sudden cardiac death, later studies have shown no benefit. This discrepancy may be due to a few factors. Firstly, the relationship between fish oil supplementation and sudden cardiac death is not a linear relationship. In other words, it does not mean that the higher the quantity of fish oils consumed, the lower the risk of sudden cardiac death.
Thirdly, given the improvement in medical treatment of heart disease over the last two decades, it has required a much larger cohort of patients to be included in trials to be able to detect the lower incidence of death from heart artery disease. Compared to post-heart attack patients 20 years ago, the likelihood of sudden cardiac death following a heart attack in present day patients is very much lower.
In a heart attack, there is damaged heart muscle and also heart muscle which is not getting adequate blood flow as a result of occlusion of the heart artery. This causes the affected heart muscle cells to be electrically unstable and this may result in the occurrence of life-threatening heart rhythms originating from the damaged muscle.
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