(22-09-07) Taking a Statin? Adding Fish Oil May Boost Its Power

Many people consume statin drugs to lower their blood LDL-cholesterol levels and reduce the likelihood of having a heart attack. However, statins have only a small effect on blood triglyceride (fat) levels. When triglycerides are elevated above normal, they increase the chance of heart disease. That?s where fish oils rich in omega-3 fatty acids enter the picture. Fish oils lower blood triglyceride levels, especially in people with very high levels. Combining statins with fish oils might improve the blood lipids of patients with high cholesterol and triglycerides.

This combined therapy has been evaluated in patients with high cholesterol and triglycerides and, as expected, improvements in the patients? blood lipids were greater with both treatments than with either one alone. In addition, these treatments increased HDL-cholesterol levels, the so-called ?good? cholesterol.

A new report from Japan, known as the JELIS Study, compared the effect of statins alone or combined with purified eicosapentaenoic acid (EPA), one of the major long-chain omega-3 fatty acids in fish oil. Participating in the study were more than 18,000 men and women, on average 61 years old. Two-thirds were postmenopausal women, all had high cholesterol and triglyceride levels and most had coronary artery disease. Study participants consumed statins alone or statins plus 1.8 g/day of EPA. That is more EPA than in 2 servings of cooked salmon.

At the end of 4? years, patients consuming both statins and EPA had 19% fewer major coronary events, 19% fewer non-fatal coronary episodes (e.g., angioplasty, non-fatal heart attack) and 24% less unstable angina than patients taking only statins. Deaths did not differ in the 2 groups. When the investigators analyzed their results based on whether the patients had coronary artery disease, the effect of statins plus EPA was significant only in patients with coronary disease. As in many other studies, fish oil or omega-3 fatty acids reduced the chance of death or myocardial infarction mainly in patients with heart disease, not in those free of the condition. For this reason, omega-3 fatty acids are considered important for the secondary prevention of heart disease.

As other studies in Japanese patients have reported, this study did not find an effect of EPA on death from heart disease. However, other large studies have reported significant reductions in heart disease mortality with the consumption of fish oil or the omega-3 fatty acids found in fish oil. One reason for this discrepancy may be that people in Japan may have already obtained most of the heart health benefits associated with fish oils, because they consume fish frequently. Indirectly, the JELIS study confirms this view, because there were very few deaths in either group over the 5-year study period.

Source: Heart Health

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