This one is about taking fish oil supplements for cardiac reasons & found it to be quite interesing for all of us to read that take these supplements. What I got from it is that you really need to EAT more fish, not take the supplements. Their studies have proven this to be true. Hope this helps someone. You may want to print this out & talk with your doctor about it... Mary

Omega 3s May Be No Help Against Stroke, MI

By Todd Neale, Senior Staff Writer, MedPage Today
Published: September 11, 2012
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco and Dorothy Caputo, MA, BSN, RN, Nurse Planner

Action Points

Omega-3 polyunsaturated fatty acid supplementation does not appear to reduce the risk of cardiovascular or cerebrovascular events, a study has found.
Note that the lack of a significant effect of omega-3 supplementation is consistent with the majority of the large studies on the topic.

Omega-3 polyunsaturated fatty acid supplementation does not appear to reduce the risk of cardiovascular or cerebrovascular events, a meta-analysis showed.

In pooled results from 20 randomized trials including more than 68,000 patients, supplementation did not reduce the risks of all-cause mortality, cardiac death, sudden death, myocardial infarction (MI), or stroke, according to Moses Elisaf, MD, PhD, of the University Hospital of Ioannina in Greece, and colleagues.

The findings "do not justify the use of omega-3 as a structured intervention in everyday clinical practice or guidelines supporting dietary omega-3 polyunsaturated fatty acid administration," the researchers reported in the Sept. 12 issue of the Journal of the American Medical Association.

"Randomized evidence will continue to accumulate in the field, yet an individual patient data meta-analysis would be more appropriate to refine possible associations related to, among others, dose, adherence, baseline intake, and cardiovascular disease risk group," they wrote.

Both European and U.S. guidelines recommend consuming omega-3s after an MI, either as supplements -- commonly in the forms of fish oil, flax seed oil, and walnut oil -- or through increased dietary consumption. However, there remains controversy about the relationship between omega-3 consumption and major cardiovascular events because some trials have shown a benefit and others have not.

Even previous meta-analyses have reported conflicting findings because of differences in methodology and outcomes examined.

So, Elisaf and colleagues performed a systematic review and meta-analysis of all randomized trials evaluating omega-3 supplementation in adults regardless of methodological study characteristics, prevention setting, or supplementation mode. They included trials with treatment lasting at least a year.

The 20 studies analyzed included 68,680 patients. Most of the studies (13) involved secondary prevention, four involved a mix of primary and secondary prevention, and three involved patients with implantable cardioverter-defibrillators.

Two of the trials used dietary counseling to increase consumption of omega-3s and the rest used supplements, at an average dose of 1.51 grams per day. Median treatment duration was 2 years.

The outcomes of interest included 7,044 deaths, 3,993 cardiac deaths, 1,150 sudden deaths, 1,837 MIs, and 1,490 strokes.

Using a P-value threshold for statistical significance of 0.0063 to account for multiple comparisons, there were no significant associations between omega-3 supplementation and any of the outcomes:
All-cause mortality (RR 0.96, 95% CI 0.91 to 1.02, P=0.17)
Cardiac death (RR 0.91, 95% CI 0.85 to 0.98, P=0.01)
Sudden death (RR 0.87, 95% CI 0.75 to 1.01, P=0.06)
MI (RR 0.89, 95% CI 0.76 to 1.04, P=0.14)
Stroke (RR 1.05, 95% CI 0.93 to 1.18, P=0.47)

None of the absolute risk reductions were statistically significant either. The lack of a significant effect of omega-3 supplementation is consistent with the majority of the large studies on the topic, according to the researchers.

"Although I prescribe omega-3 fish or plant oil capsules to some of my patients for prevention of cardiovascular disease, over the last several years the use of omega-3 supplements has become controversial," David Friedman, MD, chief of heart failure services at North Shore-Long Island Jewish's Plainview Hospital in New York, said in a statement. "This review further calls into question use of omega-3 for cardiovascular risk reduction."

However, he added, "based on the available data, even though there may be no clear cardiovascular benefit from prescribing omega-3 supplements, aside from helping to reduce triglyceride cholesterol levels, I still say it's very important for my patients to have a plant-based diet with omega-3 rich fatty fish as part of a heart-healthy Mediterranean-like dietary strategy which holds benefits probably above and beyond individual omega-3 pill supplements."

Elisaf and colleagues acknowledged some limitations of their analysis, such as the inclusion of some smaller trials, the possibility of publication and language bias or performance and detection bias, and varying baseline risk estimates and rates of treatment compliance and clinical events among the studies.

Elisaf reported having given talks, attended conferences, and participated in trials sponsored by industry but not associated with those companies that manufacture or market omega-3 supplements.