The Triglyceride-Lowering Effects of a Modest Dose of Docosahexaenoic Acid Alone Versus in Combination with Low Dose Eicosapentaenoic Acid in Patients with Coronary Artery Disease and Elevated Triglycerides
Abstract
BACKGROUND: Hypertriglyceridemia is a risk factor for coronary artery disease (CAD). The American Heart Association recommends 1000 mg of omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), daily for cardioprotection and higher doses for triglyceride-lowering in patients with CAD. METHODS: This was a prospective, randomized, double-blind study comparing DHA to DHA + EPA in patients with CAD and triglycerides greater than 200 mg/dL. Subjects were randomized to either 1000 mg of DHA or 1252 mg of DHA + EPA for eight weeks. Baseline and eight-week laboratories were drawn to assess changes in the fasting lipid profile. The primary objective was to evaluate the change in triglycerides between the two groups at eight weeks. RESULTS: A total of 116 subjects were enrolled; 57 in the DHA group and 59 in the DHA + EPA group. Baseline characteristics were similar between groups. The mean age was 69.4 +/- 9.1 years and 70.7% were male. Triglycerides decreased by an average of 21.8% in the DHA group (p < 0.001) and 18.3% in the DHA + EPA group (p < 0.001). The difference between groups was not significant. A greater proportion of subjects in the DHA group achieved triglyceride goal (less than 150 mg/dL) compared to the DHA + EPA group (24.6% versus 10.2%, p < 0.05). CONCLUSIONS: Our results indicate that the American Heart Association recommended cardioprotective dose of omega-3 fatty acids can also significantly lower triglycerides in patients with CAD. There do not appear to be significant differences in triglyceride-lowering between DHA only and DHA + EPA combination products when dosing is based on DHA.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Comparing EPA treatment with DHA treatment, or DHA treatment with OM3FA treatment, generally shows similar and small or no effects on LDL-C levels.
“Comparing EPA treatment with DHA treatment, or DHA treatment with OM3FA treatment, generally shows similar and small or no effects on LDL-C levels [18, 19, 23–26].”
Cites
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944 · see citing works
Expert Panel on Detection, E. (2001) · JAMA: The Journal of the American Medical Association · doi:10.1001/jama.285.19.2486 · Cited by 26,011 · see citing works
Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease
Kris-Etherton, P. M., Harris, W. S., & Appel, L. J. (2002) · Circulation · doi:10.1161/01.cir.0000038493.65177.94 · Cited by 3,707 · see citing works
Burr, M. L., Gilbert, J. F., Holliday, R. M., Elwood, P. C., Fehily, A. M., Rogers, S., Sweetnam, P. M., & Deadman, N. M. (1989) · The Lancet · doi:10.1016/s0140-6736(89)90828-3 · Cited by 2,610 · see citing works
The Inverse Relation between Fish Consumption and 20-Year Mortality from Coronary Heart Disease
Kromhout, D., Bosschieter, E. B., & Coulander, C. D. L. (1985) · New England Journal of Medicine · doi:10.1056/nejm198505093121901 · Cited by 2,177 · see citing works
n-3 fatty acids and serum lipoproteins: human studies
Harris, W. (1997) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/65.5.1645s · Cited by 1,243 · see citing works
Fish oils and plasma lipid and lipoprotein metabolism in humans: a critical review
Harris, W. S. (1989) · Journal of Lipid Research · doi:10.1016/s0022-2275(20)38310-3 · Cited by 1,127 · see citing works
Hypertriglyceridemia as a cardiovascular risk factor
Austin, M. A., Hokanson, J. E., & Edwards, K. L. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00031-9 · Cited by 1,066 · see citing works
Fish consumption and the 30-year risk of fatal myocardial infarction
Daviglus, M. L., Stamler, J., Orencia, A. J., Dyer, A. R., Liu, K., Greenland, P., Walsh, M. K., Morris, D., & Shekelle, R. B. (1997) · New England Journal of Medicine · doi:10.1056/nejm199704103361502 · Cited by 902 · see citing works
Incidence of hospitalized rhabdomyolysis in patients treated with lipid-lowering drugs
Graham, D. J. (2004) · JAMA · doi:10.1001/jama.292.21.2585 · Cited by 875 · see citing works
Bucher, H. C., Hengstler, P., Schindler, C., & Meier, G. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(01)01114-7 · Cited by 823 · see citing works
Risk for Myopathy With Statin Therapy in High-Risk Patients
Ballantyne, C. M., Corsini, A., Davidson, M. H., Holdaas, H., Jacobson, T. A., Leitersdorf, E., März, W., Reckless, J. P. D., & Stein, E. A. (2003) · Archives of Internal Medicine · doi:10.1001/archinte.163.5.553 · Cited by 452 · see citing works
Dolecek, T. A. (1992) · Experimental Biology and Medicine · doi:10.3181/00379727-200-43413 · Cited by 410 · see citing works
Mori, T. A., Bao, D. Q., Burke, V., Puddey, I. B., & Beilin, L. J. (1999) · Hypertension · doi:10.1161/01.hyp.34.2.253 · Cited by 407 · see citing works
Menotti, A., Kromhout, D., BLACKBURN, H. W., Fidanza, F., Buzina, R., & Nissinen, A. M. (1999) · European Journal of Epidemiology · doi:10.1023/a:1007529206050 · Cited by 373 · see citing works
Mori, T. A., Watts, G. F., Burke, V., Hilme, E., Puddey, I. B., & Beilin, L. J. (2000) · Circulation · doi:10.1161/01.cir.102.11.1264 · Cited by 359 · see citing works
Effect of Different Antilipidemic Agents and Diets on Mortality
Studer, M., Briel, M., Leimenstoll, B. M., Glass, T. R., & Bucher, H. C. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.7.725 · Cited by 317 · see citing works
Safety and Efficacy of Omacor in Severe Hypertriglyceridemia
Harris, W. S., Ginsberg, H. N., Arunakul, N., Shachter, N. S., Windsor, S. L., Adams, M., Berglund, L., & Osmundsen, K. (1997) · European Journal of Cardiovascular Prevention & Rehabilitation · doi:10.1177/174182679700400511 · Cited by 306 · see citing works
Safety and efficacy of Omacor in severe hypertriglyceridemia
Harris, W. S., Ginsberg, H. N., Arunakul, N., Shachter, N. S., Windsor, S. L., Adams, M., Berglund, L., & Osmundsen, K. (1997) · Journal of Cardiovascular Risk · doi:10.1097/00043798-199710000-00011 · Cited by 252 · see citing works
Effects of highly purified eicosapentaenoic acid and docosahexaenoic acid on hemodynamics in humans
Grimsgaard, S., Bønaa, K. H., Hansen, J., & Myhre, E. S. P. (1998) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/68.1.52 · Cited by 201 · see citing works
The cardiovascular protective role of docosahexaenoic acid
McLennan, P. L., Howe, P. R. C., Abeywardena, M. Y., Müggli, R., Raederstorff, D., Mano, M. T., Rayner, T., & Head, R. J. (1996) · European Journal of Pharmacology · doi:10.1016/0014-2999(95)00861-6 · Cited by 197 · see citing works
n−3 Fatty acids and the prevention of coronary atherosclerosis
von Schacky, C. (2000) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/71.1.224s · Cited by 186 · see citing works
Conquer, J. A., & Holub, B. J. (1996) · The Journal of Nutrition · doi:10.1093/jn/126.12.3032 · Cited by 181 · see citing works
Ågren, J. J., Hänninen, O., Julkunen, A., Fogelholm, L., Vidgren, H. M., Schwab, U., Pynnönen, O., & Uusitupa, M. I. J. (1996) · PubMed · Cited by 117 · see citing works
Triglyceride-lowering effect of omega-3 LC-polyunsaturated fatty acids--a review.
Weber, P., & Raederstorff, D. (2000) · PubMed · Cited by 106 · see citing works
Stalenhoef, A. F. H., Graaf, J. D., Wittekoek, M. E., Bredie, S. J. H., Demacker, P. N. M., & Kastelein, J. J. P. (2000) · Atherosclerosis · doi:10.1016/s0021-9150(00)00381-6 · Cited by 101 · see citing works
Davidson, M. H., Maki, K. C., Kalkowski, J., Schaefer, E. J., Torri, S. A., & Drennan, K. B. (1997) · Journal of the American College of Nutrition · doi:10.1080/07315724.1997.10718680 · Cited by 68 · see citing works
Olson, K. L. (2005) · Archives of Internal Medicine · doi:10.1001/archinte.165.1.49 · Cited by 65 · see citing works
Self-citationPrevention of cardiac sudden death by N‐3 fatty acids: a review of the evidence
Leaf, A., & Kang, J. X. (1996) · Journal of Internal Medicine · doi:10.1046/j.1365-2796.1996.449803000.x · Cited by 64 · see citing works
Deck, C. (1989) · Archives of Internal Medicine · doi:10.1001/archinte.149.8.1857 · Cited by 19 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
A Systemic Review of the Roles of n-3 Fatty Acids in Health and Disease
Riediger, N. D., Othman, R. A., Suh, M., & Moghadasian, M. H. (2009) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2008.12.022 · Cited by 694 · see citing works
Fish, docosahexaenoic acid and Alzheimer’s disease
Cunnane, S. C., Plourde, M., Pifferi, F., Bégin, M. E., Féart, C., & Barberger‐Gateau, P. (2009) · Progress in Lipid Research · doi:10.1016/j.plipres.2009.04.001 · Cited by 316 · see citing works
Ramprasath, V. R., Eyal, I., Zchut, S., & Jones, P. J. (2013) · Lipids in Health and Disease · doi:10.1186/1476-511x-12-178 · Cited by 175 · see citing works
Oscarsson, J., & Hurt-Camejo, E. (2017) · Lipids in Health and Disease · doi:10.1186/s12944-017-0541-3 · Cited by 158 · see citing works
da Cunha, J. (2015) · World Journal of Virology · doi:10.5501/wjv.v4.i2.56 · Cited by 141 · see citing works
Neff, L. M., Culiner, J., Cunningham-Rundles, S., Seidman, C., Meehan, D., Maturi, J., Wittkowski, K. M., Levine, B., & Breslow, J. L. (2011) · The Journal of Nutrition · doi:10.3945/jn.110.130021 · Cited by 121 · see citing works
Docosahexaenoic acid (DHA) and cardiovascular disease risk factors
Holub, B. J. (2009) · Prostaglandins, Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2009.05.016 · Cited by 100 · see citing works
An Improvement of Cardiovascular Risk Factors by Omega-3 Polyunsaturated Fatty Acids
Yanai, H., Masui, Y., Katsuyama, H., Adachi, H., Kawaguchi, A., Hakoshima, M., Waragai, Y., Harigae, T., & Sako, A. (2018) · Journal of Clinical Medicine Research · doi:10.14740/jocmr3362w · Cited by 93 · see citing works
Fish oil and vascular endothelial protection: Bench to bedside
Balakumar, P., & Taneja, G. (2012) · Free Radical Biology and Medicine · doi:10.1016/j.freeradbiomed.2012.05.005 · Cited by 81 · see citing works
Lien, E. L. (2009) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2009.05.004 · Cited by 78 · see citing works
Anti-Obesity Effect of Fish Oil and Fish Oil-Fenofibrate Combination in Female KK Mice
Arai, T., Kim, H.-J., Chiba, H., & Matsumoto, A. (2009) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.1313 · Cited by 74 · see citing works
Ryan, A. S., Keske, M. A., Hoffman, J. P., & Nelson, E. B. (2009) · American Journal of Therapeutics · doi:10.1097/mjt.0b013e31817fe2be · Cited by 72 · see citing works
Makhoul, Z., Kristal, A. R., Gulati, R., Luick, B. R., Bersamin, A., O’Brien, D. M., Hopkins, S. E., Stephensen, C. B., Stanhope, K. L., Havel, P. J., et al. (2011) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2011.39 · Cited by 68 · see citing works
Milte, C. M., Coates, A. M., Buckley, J. D., Hill, A. M., & Howe, P. R. C. (2007) · British Journal Of Nutrition · doi:10.1017/s000711450785344x · Cited by 61 · see citing works
Poppitt, S. D., Howe, C., Lithander, F. E., Silvers, K. M., Lin, R., Croft, J., Ratnasabapathy, Y., Gibson, R. A., & Anderson, C. S. (2009) · Stroke · doi:10.1161/strokeaha.109.555136 · Cited by 59 · see citing works
Lipid Metabolism in Treated HIV Infection
Dubé, M. P., & Cadden, J. J. (2011) · Best Practice & Research Clinical Endocrinology & Metabolism · doi:10.1016/j.beem.2011.04.004 · Cited by 53 · see citing works
Telle‐Hansen, V. H., Larsen, L. N., Høstmark, A. T., Molin, M., Dahl, L., Almendingen, K., & Ulven, S. M. (2011) · Lipids · doi:10.1007/s11745-011-3637-y · Cited by 51 · see citing works
Makhoul, Z., Kristal, A. R., Gulati, R., Luick, B. R., Bersamin, A., Boyer, B. B., & Mohatt, G. V. (2010) · American Journal of Clinical Nutrition · doi:10.3945/ajcn.2009.28820 · Cited by 48 · see citing works
Maki, K. C., Yurko‐Mauro, K., Dicklin, M. R., Schild, A. L., & Geohas, J. G. (2014) · Prostaglandins Leukotrienes and Essential Fatty Acids · doi:10.1016/j.plefa.2014.07.012 · Cited by 49 · see citing works
Jimenez-Alvarez, D., Giuffrida, F., Golay, P., Cotting, C., Lardeau, A., & Keely, B. J. (2008) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf801154r · Cited by 48 · see citing works
Safety Evaluation of Single Cell Oils and the Regulatory Requirements for Use as Food Ingredients
Ryan, A. S., Zeller, S., & NELSON, E. B. (2010) · Elsevier eBooks · doi:10.1016/b978-1-893997-73-8.50019-0 · Cited by 45 · see citing works
Engström, K., Saldeen, A.-S., Yang, B., Mehta, J. L., & Saldeen, T. G. P. (2009) · Upsala Journal of Medical Sciences · doi:10.3109/03009730903268958 · Cited by 44 · see citing works
Vaidya, H. B., & Cheema, S. K. (2014) · Food & Function · doi:10.1039/c4fo00330f · Cited by 39 · see citing works
Profiles of volatile compounds in milk containing fish oil analyzed by HS‐SPME‐GC/MS
Jimenez-Alvarez, D., Giuffrida, F., Golay, P., Cotting, C., Destaillats, F., Dionisi, F., & Keely, B. J. (2008) · European Journal of Lipid Science and Technology · doi:10.1002/ejlt.200700148 · Cited by 38 · see citing works
Deficit in prepulse inhibition in mice caused by dietary n-3 fatty acid deficiency.
Fedorova, I., Alvheim, A. R., Hussein, N., & Salem, N. (2009) · Behavioral Neuroscience · doi:10.1037/a0017446 · Cited by 38 · see citing works
Fish oil in the treatment of dyslipidemia
Goldberg, R. B., & Sabharwal, A. K. (2008) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0b013e3282f76728 · Cited by 37 · see citing works
Sun, R., Wang, X., Liu, Y., & Xia, M. (2014) · British Journal Of Nutrition · doi:10.1017/s0007114514000701 · Cited by 35 · see citing works
Harris, W. S., & Jacobson, T. A. (2009) · Elsevier eBooks · doi:10.1016/b978-141605469-6.50031-7 · Cited by 27 · see citing works
Mateos, H. T., Lewandowski, P. A., & Su, X. Q. (2011) · Lipids · doi:10.1007/s11745-011-3565-x · Cited by 24 · see citing works
Interaction of Fenofibrate and Fish Oil in Relation to Lipid Metabolism in Mice
Arai, T., Kim, H.-J., Chiba, H., & Matsumoto, A. (2009) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.e463 · Cited by 24 · see citing works
Omega-3 polyunsaturated fatty acids: a necessity for a comprehensive secondary prevention strategy
Patel, J. V. (2009) · Vascular Health and Risk Management · doi:10.2147/vhrm.s4307 · Cited by 19 · see citing works
Ω3 fatty acids may reduce hyperlipidemia in pediatric renal transplant recipients
Filler, G., Weiglein, G., Gharib, M., & Casier, S. (2012) · Pediatric Transplantation · doi:10.1111/j.1399-3046.2012.01772.x · Cited by 16 · see citing works
Ieri, F., Pinelli, P., Calamai, L., Marotta, F., & Romani, A. (2015) · Talanta · doi:10.1016/j.talanta.2015.04.026 · Cited by 16 · see citing works
Gil‐Campos, M., & Serra, J. D. (2010) · Anales de Pediatría · doi:10.1016/j.anpedi.2010.03.019 · Cited by 15 · see citing works
Speck, N., Brandsch, C., Schmidt, N., Yazdekhasti, N., Hirche, F., Lucius, R., Rimbach, G. H., Stangl, G. I., & Reiß, K. (2015) · Journal of Nutrition · doi:10.3945/jn.115.211375 · Cited by 15 · see citing works
Park, Y., & Harris, W. S. (2009) · Journal of Medicinal Food · doi:10.1089/jmf.2008.1250 · Cited by 13 · see citing works
Offman, E. M., Davidson, M. H., Abu-Rashid, M., Chai, P., & Nilsson, C. A. M. (2017) · European Journal of Drug Metabolism and Pharmacokinetics · doi:10.1007/s13318-016-0398-2 · Cited by 12 · see citing works
Sparkes, C., Gibson, R. A., Sinclair, A. J., Else, P. L., & Meyer, B. J. (2018) · Nutrients · doi:10.3390/nu10101460 · Cited by 10 · see citing works
Current issues and perspectives in prenatal nutrition
Pill, Morrison, J. C., & Pill (2011) · Research and Reports in Neonatology · doi:10.2147/rrn.s19797 · Cited by 4 · see citing works
The Impact of Modern Antiretroviral Therapy on Lipid Metabolism of HIV-1 Infected Patients
da Cunha, J., Maselli, L. M. F., Bydlowski, S. P., & Spada, C. (2015) · InTech eBooks · doi:10.5772/61061 · Cited by 2 · see citing works
Recent Developments in the Human Nutrition of Polyunsaturated Fatty Acids from Single Cell Oils
Kuratko, C. N., Hoffman, J. P., Elswyk, M. E. V., & Salem, N. (2010) · Elsevier eBooks · doi:10.1016/b978-1-893997-73-8.50021-9 · Cited by 2 · see citing works
Amir, K., Watanabe, M., Yokotsuka, M., & Kobayashi, Y. (2012) · Ningen dock : official journal of the Japanese Society of Human Dry Dock · doi:10.11320/ningendock.26.927 · Cited by 2 · see citing works
Ryan, A. S., Porter, S. S., & Sancilio, F. D. (2013) · Food and Nutrition Sciences · doi:10.4236/fns.2013.41002
Tsiami, A. A., Sookhoo, D., Tingle, A., Loveday, H. P., & Golsorkhi, M. (2012) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/jbisrir-2012-291
Clinical and Experimental Evidence on Cardiovascular Benefits of Fish Oil
Moghadasian, M. H., & Riediger, N. D. (2012) · CRC Press eBooks · doi:10.1201/b11562-4
Дадали, В. А., & Sokolova, E. V. (2022) · Terapevt (General Physician) · doi:10.33920/med-12-2209-05
Harris, W. S., & Jacobson, T. A. (2015) · Elsevier eBooks · doi:10.1016/b978-0-323-28786-9.00026-8
- Authors
- Schwellenbach, L. J., Olson, K. L., McConnell, K. J., Stolcpart, R. S., Nash, J. D., Merenich, J. A., & for the Clinical Pharmacy Cardiac Risk Service Study Group
- Affiliations
- Kaiser Permanente (US)
- Humana (United States) (US)
- Colorado Permanente Medical Group (US)
- Corresponding author
- Olson, Kari L.
- ORCID
- Olson, Kari L.
- Venue
- Journal of the American College of Nutrition
- Publisher
- Informa UK Limited
- Published
- 2006-12
- Volume
- 25
- Issue
- 6
- Pages
- 480-485
- ISSN
- 0731-5724 (ISSN-L)
- 1541-1087
- OpenAlex
- W2074147578
- Cited by
- 48
- References
- 32
- Citations by year
- 2022: 1 · 2018: 2 · 2017: 2 · 2015: 5 · 2014: 3 · 2013: 2 · 2012: 6
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of the American College of Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Life Sciences › Agricultural and Biological Sciences › Aquatic Science › Aquaculture Nutrition and Growth
- Keywords
- docosahexaenoic acid, eicosapentaenoic acid, omega-3 fatty acids, triglyceride lowering, hypertriglyceridemia, coronary artery disease, lipid profile, dietary supplementation
- MeSH terms
- Aged, Coronary Artery Disease, Docosahexaenoic Acids, Dose-Response Relationship, Drug, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Male, Prospective Studies, Risk Factors, Triglycerides, Eicosapentaenoic Acid, Hypertriglyceridemia, Treatment Outcome, Lipid Metabolism
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
