Marine n−3 Fatty Acids and Prevention of Cardiovascular Disease and Cancer
Open accessAbstract
BACKGROUND: Higher intake of marine n-3 (also called omega-3) fatty acids has been associated with reduced risks of cardiovascular disease and cancer in several observational studies. Whether supplementation with n-3 fatty acids has such effects in general populations at usual risk for these end points is unclear. METHODS: (at a dose of 2000 IU per day) and marine n-3 fatty acids (at a dose of 1 g per day) in the primary prevention of cardiovascular disease and cancer among men 50 years of age or older and women 55 years of age or older in the United States. Primary end points were major cardiovascular events (a composite of myocardial infarction, stroke, or death from cardiovascular causes) and invasive cancer of any type. Secondary end points included individual components of the composite cardiovascular end point, the composite end point plus coronary revascularization (expanded composite of cardiovascular events), site-specific cancers, and death from cancer. Safety was also assessed. This article reports the results of the comparison of n-3 fatty acids with placebo. RESULTS: A total of 25,871 participants, including 5106 black participants, underwent randomization. During a median follow-up of 5.3 years, a major cardiovascular event occurred in 386 participants in the n-3 group and in 419 in the placebo group (hazard ratio, 0.92; 95% confidence interval [CI], 0.80 to 1.06; P=0.24). Invasive cancer was diagnosed in 820 participants in the n-3 group and in 797 in the placebo group (hazard ratio, 1.03; 95% CI, 0.93 to 1.13; P=0.56). In the analyses of key secondary end points, the hazard ratios were as follows: for the expanded composite end point of cardiovascular events, 0.93 (95% CI, 0.82 to 1.04); for total myocardial infarction, 0.72 (95% CI, 0.59 to 0.90); for total stroke, 1.04 (95% CI, 0.83 to 1.31); for death from cardiovascular causes, 0.96 (95% CI, 0.76 to 1.21); and for death from cancer (341 deaths from cancer), 0.97 (95% CI, 0.79 to 1.20). In the analysis of death from any cause (978 deaths overall), the hazard ratio was 1.02 (95% CI, 0.90 to 1.15). No excess risks of bleeding or other serious adverse events were observed. CONCLUSIONS: Supplementation with n-3 fatty acids did not result in a lower incidence of major cardiovascular events or cancer than placebo. (Funded by the National Institutes of Health and others; VITAL ClinicalTrials.gov number, NCT01169259 .).
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Among outcomes trials with omega-3 preparations, only REDUCE-IT has shown cardiovascular benefits.
“although only REDUCE-IT has shown cardiovascular benefits (as discussed later) (14-17).”
From 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia (2021) · cites this paper as [16]
The discussion (p. 30) says two earlier large trials showed significant protection against coronary events and that one subsequent placebo-controlled trial did as well. The Cardiovascular Disease results also report lower risks of myocardial infarction and coronary heart disease in this trial, although its primary cardiovascular endpoint was not significantly reduced. The source therefore contradicts the assertion that only REDUCE-IT showed cardiovascular benefits. (LLM, conf=0.90)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredSeveral large clinical trials failed to demonstrate any cardiovascular benefit with administration of low doses of omega-3 fatty acids.
“butseverallargeclinicaltrialsfailed to demonstrate any cardiovascular benefit with administration of low doses of omega-3 fatty acids. 8,12,13”
From Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk (2020) · cites this paper as [13]
The Discussion reports that this 1-g/day trial did not significantly reduce major cardiovascular events and that other trials had generally null results. But it also reports a lower risk of myocardial infarction in this trial, while the passage labeled p. 30 notes coronary protection in two early large trials. Thus, “any cardiovascular benefit” overstates what the paper says. (LLM, conf=0.88)
Experimental — accuracy not yet measuredThe STRENGTH, VITAL, ASCEND, ORIGIN, OMEGA, ALPHA-OMEGA, GISSI-HF and GISSI-P trials randomized patients to receive either a combination of EPA and DHA or placebo; yet only the GISSI trials noted a statistically significant effect on cardiovascular events and mortality.
“The STRENGTH, VITAL, ASCEND, ORIGIN, OMEGA, ALPHA-OMEGA, GISSI-HF and GISSI-P trials randomized patients to receive either a combination of EPA and DHA or placebo; yet only the GISSI trials noted a statistically significant effect on cardiovascular events and mortality [96–103].”
From Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention (2023) · cites this paper as [96]
Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.
Experimental — accuracy not yet measuredIn the VITAL trial, supplementation with 1 g of omega-3 fatty acids did not result in a lower incidence of major cardiovascular events in participants, 13% of whom had type 2 diabetes.
“TheVitaminDandOmega-3Trial(VITAL), in which 13% of the participants had type 2 diabetes, supplementation with 1 g of omega-3 fatty acids did not result in a lower incidence of major cardiovascular events (305).”
From Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report (2019) · cites this paper as [305]
The Discussion reports that 1 g per day of n−3 fatty acids did not significantly lower the incidence of major cardiovascular events. The baseline-characteristics table, reproduced in the Cancer and All-Cause Mortality section, reports diabetes in 13.7% of participants, but does not identify it specifically as type 2 diabetes; it also gives a figure closer to 14% than 13%. (LLM, conf=0.85)
Experimental — accuracy not yet measuredClinical trials revealed that omega-3 PUFA supplementation of <1 g/d resulted in a very limited reduction in atherosclerotic CVD risk of major vascular events and CVD-caused deaths.
“Clinical trials revealed that ω3 PUFA supplementation of <1 g/d resulted in a very limited reduction in atherosclerotic CVD risk of major vascular events and CVD‐caused deaths. 22 , 23 , 133 , 154”
From Association Between Omega-3 Fatty Acid Intake and Dyslipidemia: A Continuous Dose-Response Meta-Analysis of Randomized Controlled Trials (2023) · cites this paper as [23]
The Discussion reports that meta-analyses found no, or at most a weak, preventive effect on cardiovascular outcomes, which supports the characterization of a very limited benefit. But this trial tested 1 g/day, not less than 1 g/day, and its Cardiovascular Disease results found no statistically significant reduction in major cardiovascular events or cardiovascular deaths. (LLM, conf=0.88)
Experimental — accuracy not yet measured
The inclusion rate in OMEMI was 26% of screened candidates, which is relatively low compared to other n-3 PUFA trials not targeting elderly patients.
“A limitation to the study is the inclusion rate of 26 % of screened candidates, which is relatively low compared to other n-3 PUFA trials not targeting elderly patients 30-33 .”
From Effects of n-3 Fatty Acid Supplements in Elderly Patients After Myocardial Infarction (2021) · cites this paper as [31]
The Trial Design and Oversight section identifies this as an n-3 fatty-acid trial enrolling men aged 50 or older and women aged 55 or older, so it is a relevant trial for comparison. The Trial Participants section reports 25,871 participants but gives no screened-candidate count or inclusion rate; our copy therefore does not establish that OMEMI’s 26% rate was lower. (LLM, conf=0.78)
Experimental — accuracy not yet measuredThese earlier trials showed inconsistent reductions in MACE.
“These studies showed inconsistent reductions in MACE.”
From Targeting Triglycerides in Cardiovascular Disease Prevention: Evidence, Mechanisms, and Emerging Therapies (2026) · cites this paper as [89]
The Discussion reports inconsistent findings across earlier trials for coronary events: two early trials found significant protection, whereas nearly all subsequent placebo-controlled trials did not. But it says neither this trial nor the secondary-prevention trials indicated a benefit for composite cardiovascular end points, so the inconsistency is not established for MACE specifically. (LLM, conf=0.84)
Experimental — accuracy not yet measuredMultiple large studies of low-dose EPA/DHA mixtures with contemporary background therapy including statin have failed to show significant reduction in cardiovascular endpoints.
“Multiple large studies conducted since then to examine the benefits of low-dose mixtures of EPA and DHA with more contemporary background therapy, including statin therapy, have failed to show any significant reduction in cardiovascular endpoints.”
From 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia (2021) · cites this paper as [16]
The Discussion (p. 30) says most subsequent placebo-controlled n-3 trials did not show significant protection against coronary events and notes greater use of cardiovascular medications, including statins, in recent trials. But “any significant reduction in cardiovascular endpoints” is too broad: the Cardiovascular Disease results report lower myocardial infarction and PCI rates with the EPA/DHA mixture, despite no significant reduction in the primary composite endpoint. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOther recent trials studying lower doses of omega-3 fatty acids in a broader range of patients failed to demonstrate significant reductions of total cardiovascular events.
“However, other recent trials studying lower doses of omega-3 fatty acids in a broader range of patients failed to demonstrate significant reductions of total cardiovascular events. 12,13”
From Effect of High-Dose Omega-3 Fatty Acids vs Corn Oil on Major Adverse Cardiovascular Events in Patients at High Cardiovascular Risk (2020) · cites this paper as [13]
This may explain why EPA + DHA combination treatment in various trials did not demonstrate an effect on reducing cardiovascular risk.
“This may explain why EPA + DHA combination treatment in various trials did not demonstrate an effect on reducing cardiovascular risk. 23 , 24 , 25 , 133”
From Association Between Omega-3 Fatty Acid Intake and Dyslipidemia: A Continuous Dose-Response Meta-Analysis of Randomized Controlled Trials (2023) · cites this paper as [23]
Earlier trials GISSI-Prevenzione, ASCEND, VITAL, and OMEMI evaluated low-dose EPA/DHA mixtures primarily in primary prevention settings or post-MI patients, often without significant baseline TG elevation and with limited use of statins in earlier trials.
“Earlier trials such as GISSI-Prevenzione, ASCEND, VITAL, and OMEMI evaluated low-dose EPA/DHA mixtures primarily in primary prevention settings or post-MI patients, often without significant baseline TG elevation and with limited use of statins in earlier trials [87–90].”
From Targeting Triglycerides in Cardiovascular Disease Prevention: Evidence, Mechanisms, and Emerging Therapies (2026) · cites this paper as [89]
The ASCEND and VITAL trials using EPA+DHA did not significantly reduce the primary cardiovascular endpoints.
“The ASCEND (A Study of Cardiovascular Events in Diabetes) [3] and VITAL (Vitamin D and Omega-3 Trial) trials [5] using EPA+DHA did not signi fi cantly reduce the primary cardiovascular endpoints”
From Effect of omega-3 fatty acids on cardiovascular outcomes: A systematic review and meta-analysis (2021) · cites this paper as [5]
In VITAL, during a median follow-up of 5.3 years, there was no significant difference in major cardiovascular events or invasive cancer between fish oil and placebo.
“During a median follow-up of 5.3 years, there was no significant difference in the 2 primary endpoints of major cardiovascular events (a composite of MI, stroke, or death from cardiovascular causes) or invasive cancer of any type.”
From 2021 ACC Expert Consensus Decision Pathway on the Management of ASCVD Risk Reduction in Patients With Persistent Hypertriglyceridemia (2021) · cites this paper as [16]
Contemporary ω-3 fatty acid trials were conducted with higher standards and consistently failed to demonstrate significant cardiovascular benefits.
“Contemporary studies were conducted with higher standards and consistently failed to demonstrate significant benefits.”
At lower doses (1 g/day), omega-3 fatty acids have generally failed to show reduced ASCVD.
“at lower doses (1 g/day) these agents have generally failed to show reduced ASCVD.50,51”
From Clinical review on triglycerides (2020) · cites this paper as [51]
Pemafibrate has been reported to have marked efficacy in reducing triglyceride-rich lipoproteins.
“Recently, a new selective PPAR-α modulator (pemafibrate) has been reported to have marked efficacy in reducing TRLs [317].”
From 2019 ESC/EAS guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk (2019) · cites this paper as [317]
The VITAL trial showed that just 840 mg of combined EPA/DHA significantly reduced MI and major CHD events.
“However, this trial showed that just 840 mg of combined EPA/DHA significantly reduced MI and major CHD events [63].”
From Update on Omega-3 Polyunsaturated Fatty Acids on Cardiovascular Health (2022) · cites this paper as [63]
The VITAL trial did not show that supplementing with n-3 fatty acids reduced the incidence of major CVD events or invasive cancer.
“This study did not show that supplementing with n-3 fatty acids reduced the incidence of major CVD events (a composite of MI, stroke, and death from CVD causes) or invasive cancer.”
From Update on Omega-3 Polyunsaturated Fatty Acids on Cardiovascular Health (2022) · cites this paper as [63]
In VITAL, participants with low baseline fish intake, under 1.5 servings per week, had lower risk of total cardiovascular events, with a hazard ratio of 0.81 and 95% confidence interval 0.67 to 0.98.
“Individuals with low baseline fish consumption (<1.5 servings/week) had decreased risk for total CV events (hazard ratio [HR]: 0.81; 95% confidence interval [CI]: 0.67 to 0.98).”
From Cardiovascular Impact of Nutritional Supplementation With Omega-3 Fatty Acids (2021) · cites this paper as [61]
In VITAL, total myocardial infarction was reduced by 28%, with the reduction appearing after the first year and continuing through the trial.
“However, there was a 28% reduction in total MI, which emerged after the first year and continued throughout the trial.”
From Cardiovascular Impact of Nutritional Supplementation With Omega-3 Fatty Acids (2021) · cites this paper as [61]
In VITAL, omega-3 PUFAs did not significantly reduce the primary composite endpoint of major ASCVD events.
“In the VITAL trial, omega-3 PUFAs did not significantly reduce the primary composite endpoint of major ASCVD events (MI, stroke, and CVD mortality).”
From Cardiovascular Impact of Nutritional Supplementation With Omega-3 Fatty Acids (2021) · cites this paper as [61]
In VITAL, Black participants had a 77% treatment-associated reduction in myocardial infarction, with a hazard ratio of 0.23 and 95% confidence interval 0.11 to 0.47, and benefited regardless of baseline fish intake.
“Black study participants experienced a 77% treatment-associated reduction in MI (HR: 0.23; 95% CI: 0.11 to 0.47), and derived an MI benefit irrespective of baseline fish intake.”
From Cardiovascular Impact of Nutritional Supplementation With Omega-3 Fatty Acids (2021) · cites this paper as [61]
In VITAL, other prespecified secondary outcomes were significantly reduced, including a 17% lower risk of total coronary heart disease and a 50% reduction in fatal myocardial infarction.
“There were significant reductions in other pre-specified secondary outcomes, including a 17% reduced risk for total coronary heart disease (CHD) and a 50% reduction in fatal MI”
From Cardiovascular Impact of Nutritional Supplementation With Omega-3 Fatty Acids (2021) · cites this paper as [61]
In the statin era, cardiovascular outcomes trials of combination omega-3 fatty acids (EPA and DHA) have not shown reduction in cardiovascular disease events.
“In the statin era, CVOTs of combination OM-3 fatty acids [eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)] have not shown reduction in cardiovascular disease (CVD) events.”
From Critical Differences Between Dietary Supplement and Prescription Omega-3 Fatty Acids: A Narrative Review (2020) · cites this paper as [11]
Additional factors that may influence cardiovascular outcomes trial findings include omega-3 dose, definition of primary composite cardiovascular endpoint, and study population.
“Additional factors that may influence CVOT findings include OM-3 dose, definition of primary composite CV endpoint, and study population.”
From Critical Differences Between Dietary Supplement and Prescription Omega-3 Fatty Acids: A Narrative Review (2020) · cites this paper as [11]
The total daily dose of omega-3 was much lower in VITAL and ASCEND (<1 g/day total omega-3 per each 1-g capsule) than in REDUCE-IT (4 g/day high-purity prescription EPA).
“The total daily dose of OM-3 was much lower in VITAL and ASCEND (< 1 g/day total OM-3 per each 1-g capsule) than in REDUCE-IT (4 g/day high-purity Rx EPA).”
From Critical Differences Between Dietary Supplement and Prescription Omega-3 Fatty Acids: A Narrative Review (2020) · cites this paper as [11]
The primary composite cardiovascular endpoint varied between the recent omega-3 cardiovascular outcomes trials.
“The primary composite CV endpoint varied between the studies (Table 1, see footnote); for example, in REDUCE-IT, coronary revascularization and unstable angina were included, in addition to CV death, nonfatal myocardial infarction, and nonfatal stroke.”
From Critical Differences Between Dietary Supplement and Prescription Omega-3 Fatty Acids: A Narrative Review (2020) · cites this paper as [11]
A 17% risk reduction was recorded for total coronary heart disease, versus placebo.
“A 17% risk reduction was recorded for total coronary heart disease, versus placebo.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [53]
An in-depth analysis of the VITAL study results demonstrated an 8% reduction in major cardiovascular events, though not statistically significant.
“Indeed, while the primary outcome of the study, a reduction in major cardiovascular events (a composite of myocardial infarction, stroke, and death from cardiovascular causes), was not achieved with statistical significance, the analysis did demonstrate an 8% reduction in such events.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [53]
For African-Americans, the study found a dramatic 77% reduction in heart attacks linked to daily omega-3 supplementation.
“Interestingly for African-Americans, the study found a dramatic 77% reduction in heart attacks linked to daily omega-3 supplementation.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [53]
In people who do not consume the recommended 1 or 2 servings of fish a week, the n-3 LCPUFA supplementation was linked to a 40% reduction in heart attacks; however, among the subjects who followed the fish consumption recommendation, there was no such association.
“In people who do not consume the recommended 1 or 2 servings of fish a week, the n-3 LCPUFA supplementation was linked to a 40% reduction in heart attacks; however, among the subjects who followed the fish consumption recommendation, there was no such association.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [53]
The primary conclusion of the VITAL study was not positive regarding the effect of supplementation with n-3 LCPUFA on major cardiovascular events as the data failed to show a lower incidence of major cardiovascular events in the experimental group than in the placebo control group.
“The primary conclusion of the VITAL study was not positive regarding the effect of supplementation with n-3 LCPUFA on major cardiovascular events as the data failed to show a lower incidence of major cardiovascular events in the experimental group than in the placebo control group [53].”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [53]
Omega-3 supplementation was associated with a reduction in total and fatal myocardial infarction risk by 28% and 50%, respectively.
“However, the secondary outcomes were highly relevant as omega-3 supplementation was associated with a reduction in total and fatal myocardial infarction risk by 28% and 50%, respectively.”
From Role of n-3 long-chain polyunsaturated fatty acids in human nutrition and health: Review of recent studies and recommendations (2021) · cites this paper as [53]
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Updated Cardiovascular Prevention Guideline of the Brazilian Society of Cardiology - 2019
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“Baseline characteristics of the 25 871 participants were balanced between treatment and placebo groups (table 1; details of the cohort given by Manson and colleagues 20 ).”
BackgroundSelf-citationEmerging Mechanisms of Cardiovascular Protection for the Omega-3 Fatty Acid Eicosapentaenoic Acid
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“The ASCEND (A Study of Cardiovascular Events in Diabetes) [3] and VITAL (Vitamin D and Omega-3 Trial) trials [5] using EPA+DHA did not significantly reduce the primary cardiovascular endpoints (ASCEND: non-fatal myocardial infarction [MI] or ischemic stroke, transient ischemic attack, or vascular death excluding confi…”
BackgroundHu, Y., Hu, F. B., & Manson, J. E. (2019) · Journal of the American Heart Association · doi:10.1161/jaha.119.013543 · Cited by 388 · see citing works
“The VITAL (Vitamin D and Omega-3 Trial), which included 25 871 participants at “usual” risk of CVD from the general population, also did not find a statistically significant reduction in the primary end point of major CVD events.(10) However, both ASCEND and VITAL found reductions in at least 1 prespecified secondary…”
ResultSelf-citationTargeting cancer-promoting inflammation — have anti-inflammatory therapies come of age?
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Marine Omega-3 (N-3) Fatty Acids for Cardiovascular Health: An Update for 2020
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“The Vitamin D and Omega-3 Trial (VITAL) trial randomised 25,871 healthy participants aged over 50 years (men) and 55 years (women) to receive marine n-3 fatty acids (840 mg/d EPA+DHA) and/or vitamin D (2000 IU/d) or placebo [54].”
BackgroundBischoff-Ferrari, H. A., Vellas, B., Rizzoli, R., Kressig, R. W., da Silva, J. A. P., Blauth, M., Felson, D. T., McCloskey, E. V., Watzl, B., Hofbauer, L. C., et al. (2020) · JAMA · doi:10.1001/jama.2020.16909 · Cited by 353 · see citing works
Self-citationLipid Management for the Prevention of Atherosclerotic Cardiovascular Disease
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“Omega-3 fatty acids enhance the electrical-stability of heart cells, thereby extending its relative refractory period and helping treat arrhythmias [75,76].”
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“The addition of omega-3 PUFAs to the diet could decrease LDL-cholesterol, prevent myocardial infarction, and reduce the morbidity and mortality of cardio-vascular disease [8 – 10].”
New Guidelines for Statistical Reporting in the Journal
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BackgroundThe Short Overview on the Relevance of Fatty Acids for Human Cardiovascular Disorders
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“VITAL reported a significant reduction in risk of, and death from, either myocardial infarction or CHD in patients receiving EPA+DHA (840 mg/day) [7].”
BackgroundPoLA/CFPiP/PCS/PSLD/PSD/PSH guidelines on diagnosis and therapy of lipid disorders in Poland 2021
Banach, M., Burchardt, P., Chlebus, K., Dobrowolski, P., Dudek, D., Dyrbuś, K., Gąsior, M., Jankowski, P., Jozwiak, J. J., Kłosiewicz−Latoszek, L., et al. (2021) · Archives of Medical Science · doi:10.5114/aoms/141941 · Cited by 163 · see citing works
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Encapsulation and Protection of Omega-3-Rich Fish Oils Using Food-Grade Delivery Systems
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BackgroundGenomics in Personalized Nutrition: Can You “Eat for Your Genes”?
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“Additionally, consideration of genetic ancestry could provide necessary information required to understand results such as racial/ethnic differences in the efficacy of omega-3 supplementation [23,36,130].”
BackgroundVitamin D Metabolites: Analytical Challenges and Clinical Relevance
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“Large randomized intervention studies, such as the VITAL study (25,000 individuals aged 50 years or older treated with 2000 IU/day of vitamin D and 1 g/day of omega-3 fatty acid for over 5 years) [101] and the VIDA study (5000 individuals over 50 years of age treated with an initial dose of 200,000 IU and then 100,000…”
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“New clinical data Data from 2 large human intervention studies, the Vitamin D and Omega-3 Trial (VITAL) [53] and the Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT) [54], were published in late 2018, thereby adding considerable insights on the role of n-3 LCPUFA in CVD and how th…”
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“3 years did not reduce the risk of major cardiovascular events than the placebo without an increase in HDL-C, compared to the vitamin D3 (2000 IU/d) group (n = 12,938) as a placebo [47].”
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“placebo in prevention of cardiovascular disease and cancer [61].”
BackgroundHealth effects of vitamin and mineral supplements
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“different chronic degenerative diseases, 12–16 recent large trials have been inconclusive for normal subjects.(17) The role of the gut microbiome and individual variation in modulating these effects are yet to be explored.”
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“…Group 2018 [22] RCT 15,480 patients with diabetes aged ≥ 40 years Omega-3 fatty acids Mean: 7.4 years No effect on serious vascular events Manson et al., 2019 [23] RCT 25,871 patients aged≥ 50 years Omega-3 fatty acids Median: 5.3 years No effect on cardiovascular events Bhatt et al.,…”
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The Diagnosis and Treatment of Hypertriglyceridemia
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“In the same sense, although recent RCTs as the REDUCE-IT trial (Bhatt et al. 2018) showed that a certain amount and type of n-3 PUFA decreased CVD events, other subsequent RCTs such as the ASCEND (Bowman et al. 2018) and the VITAL (Manson et al. 2019) did not find any significant impact of n-3 PUFA on CVD morbidity an…”
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Established and Emerging Lipid-Lowering Drugs for Primary and Secondary Cardiovascular Prevention
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Chinese Guideline on the Primary Prevention of Cardiovascular Diseases
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Improving natural product research translation: From source to clinical trial
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“3 years, no differences in the incidence of invasive cancer or cardiovascular events were shown compared to the placebo group [110].”
BackgroundHealth Benefits, Food Applications, and Sustainability of Microalgae-Derived N-3 PUFA
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“In this subgroup of the participants, a 40% reduction was realized by n-3 PUFA supplementation as compared with the placebo group [35].”
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Clinical Advances in Immunonutrition and Atherosclerosis: A Review
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“Yusof et al. (34) also observed a slight decrease in plasma sICAM-1 concentrations after administering 1.8 g of EPA plus 0.3 g DHA daily for 8 weeks in 10 healthy middle-aged men.”
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Inflammation and cardiovascular disease: are marine phospholipids the answer?
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- Authors
- Manson, J. E., Cook, N. R., Lee, I.-M., Christen, W., Bassuk, S. S., Mora, S., Gibson, H., Albert, C. M., Gordon, D., Copeland, T., D’Agostino, D., Friedenberg, G., Ridge, C., Bubes, V., Giovannucci, E. L., Willett, W. C., & Buring, J. E.
- Affiliations
- Brigham and Women's Hospital (US)
- From the Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School (J.E.M., N.R.C., I-M.L., W.C., S.S.B., S.M., H.G., C.M.A., D.G., T.C., D.D., G.F., C.R., V.B., E.L.G., W.C.W., J.E.B.), and the Departments of Epidemiology (J.E.M., N.R.C., I.-M.L., W.C.W., J.E.B.) and Nutrition (E.L.G., W.C.W.), Harvard T.H. Chan School of Public Health — all in Boston.
- ORCID
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2019-01-03
- Volume
- 380
- Issue
- 1
- Pages
- 23-32
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- PMC
- PMC6392053
- OpenAlex
- W2899720772
- Semantic Scholar
- bb3183c85d8686140abdf23d14174712153d2ed2
- Cited by
- 979
- References
- 94
- Citations by year
- 2026: 78 · 2025: 93 · 2024: 98 · 2023: 121 · 2022: 130 · 2021: 136 · 2020: 162 · 2019: 141 · 2018: 17 · 2014: 1
- FWCI
- 94.27
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Heart, Lung, and Blood Institute (R0 CA138962)
- National Cancer Institute
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
- Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
- Keywords
- omega-3 fatty acids, cardiovascular disease prevention, cancer prevention, primary prevention, cardiovascular events, myocardial infarction, stroke, cancer mortality, coronary revascularization, dietary supplementation, cardiovascular risk reduction, cancer risk reduction, older adults, Black participants, cancer risk factors
- MeSH terms
- Aged, Cardiovascular Diseases, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neoplasms, Fatty Acids, Omega-3, Incidence, Treatment Failure
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